Name: introduction of intracapsular rotary-cut procedures (ircp): a modified hysteromyomectomy procedures facilitating fertility preservation
Uploaded: 2019-01-17T12:30:00
Description: Watch this Scientific Journal Video about Introduction of Intracapsular Rotary-cut Procedures IRCP: A Modified Hysteromyomectomy Procedures Facilitating Fertility Preservation at JoVE.com

以下程序的所有程序都于2012年12月15日得到北京大学深圳医院机构审查委员会的审查和批准, 并适用于患者。
1. 患者准备
<ol><li>采用以下纳入标准: 异常子宫出血;纤维瘤压迫周围器官, 引起泌尿系统、消化性或性症状;不孕不育;当患者准备怀孕时, 纤维瘤大于4厘米。</li>
	<li>使用以下排除标准: 疑似恶性肿瘤;疑似纤维瘤变性;结节、颈椎或广泛的韧带肌瘤;促性腺激素释放激素类...

<ol>
	<li>Drayer, S. M., Catherino, W. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prevalence,+morbidity,+and+current+medical+management+of+uterine+leiomyomas.">Prevalence, morbidity, and current medical management of uterine leiomyomas.</a> International Journal of Gynecology &amp; Obstetrics. 131 (2), 117-122 (2015).</li><li>Wu, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prevalence+and+clinical+significance+of+mediator+complex+subunit+12+mutations+in+362+Han+Chinese+samples+with+uterine+leiomyoma.">Prevalence and clinical significance of mediator complex subunit 12 mutations in 362 Han Chinese samples with uterine leiomyoma.</a> Oncology Letters. 14 (1), 47-54 (2017).</li><li>Falcone, T., Parker, W. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Surgical+management+of+leiomyomas+for+fertility+or+uterine+preservation.">Surgical management of leiomyomas for fertility or uterine preservation.</a> Obstetrics &amp; Gynecology. 121 (4), 856-868 (2013).</li><li>Donnez, J., Dolmans, M. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Uterine+fibroid+management:+from+the+present+to+the+future.">Uterine fibroid management: from the present to the future.</a> Human Reproduction Update. 22 (6), 665-686 (2016).</li><li>Gu, Y., Zhu, L., Liu, A., Ma, J., Lang, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Analysis+of+hysterectomies+for+patients+with+uterine+leiomyomas+in+China+in+2010.">Analysis of hysterectomies for patients with uterine leiomyomas in China in 2010.</a> International Journal of Gynecology &amp; Obstetrics. 129 (1), 71-74 (2015).</li><li>Cheng, P. J., Duan, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=China's+new+two-child+policy:+maternity+care+in+the+new+multiparous+era.">China's new two-child policy: maternity care in the new multiparous era.</a> BJOG. 123, 7-9 (2016).</li><li>Tinelli, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Laparoscopic+myomectomy+focusing+on+the+myoma+pseudocapsule:+technical+and+outcome+reports.">Laparoscopic myomectomy focusing on the myoma pseudocapsule: technical and outcome reports.</a> Human Reproduction. 27 (2), 427-435 (2012).</li><li>Agdi, M., Tulandi, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Minimally+invasive+approach+for+myomectomy.">Minimally invasive approach for myomectomy.</a> Seminars in Reproductive Medicine. 28 (3), 228-234 (2010).</li><li>Al-Talib, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Factors+contributing+to+failure+of+laparoscopic+myomectomy.">Factors contributing to failure of laparoscopic myomectomy.</a> Surgical Technology International. 23, 149-151 (2013).</li><li>Saccardi, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Limits+and+complications+of+laparoscopic+myomectomy:+which+are+the+best+predictors?+A+large+cohort+single-center+experience.">Limits and complications of laparoscopic myomectomy: which are the best predictors? A large cohort single-center experience.</a> Archives of Gynecology and Obstetrics. 290 (5), 951-956 (2014).</li><li>Sizzi, O., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Italian+multicenter+study+on+complications+of+laparoscopic+myomectomy.">Italian multicenter study on complications of laparoscopic myomectomy.</a> Journal of Minimally Invasive Gynecology. 14 (4), 453-462 (2007).</li><li>Buckley, V. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Laparoscopic+myomectomy:+clinical+outcomes+and+comparative+evidence.">Laparoscopic myomectomy: clinical outcomes and comparative evidence.</a> Journal of Minimally Invasive Gynecology. 22 (1), 11-25 (2015).</li><li>Glaser, L. M., Friedman, J., Tsai, S., Chaudhari, A., Milad, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Laparoscopic+myomectomy+and+morcellation:+A+review+of+techniques,+outcomes,+and+practice+guidelines.">Laparoscopic myomectomy and morcellation: A review of techniques, outcomes, and practice guidelines.</a> Best Practice &amp; Research: Clinical Obstetrics &amp; Gynaecology. 46, 99-112 (2018).</li><li>Kelly, B. A., Bright, P., Mackenzie, I. Z. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Does+the+surgical+approach+used+for+myomectomy+influence+the+morbidity+in+subsequent+pregnancy.">Does the surgical approach used for myomectomy influence the morbidity in subsequent pregnancy.</a> Journal of Obstetrics &amp; Gynaecology. 28 (1), 77-81 (2008).</li><li>Tian, Y. C., Long, T. F., Dai, Y. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pregnancy+outcomes+following+different+surgical+approaches+of+myomectomy.">Pregnancy outcomes following different surgical approaches of myomectomy.</a> Journal of Obstetrics and Gynaecological Research. 41 (3), 350-357 (2015).</li><li>Zhong, S. L., Zeng, L. P., Li, H., Wu, R. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+and+evaluation+of+an+improved+laparoscopic+myomectomy+adopting+intracapsular+rotary-cut+procedures.">Development and evaluation of an improved laparoscopic myomectomy adopting intracapsular rotary-cut procedures.</a> European Journal of Obstetrics &amp; Gynecology and Reproductive Biology. 221, 5-11 (2018).</li><li>Vilos, G. A., Allaire, C., Laberge, P. Y., Leyland, N., Special, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+management+of+uterine+leiomyomas.">The management of uterine leiomyomas.</a> Journal of Obstetrics and Gynaecology Canada. 37 (2), 157-178 (2015).</li><li>Lethaby, A., Vollenhoven, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fibroids+(uterine+myomatosis,+leiomyomas).">Fibroids (uterine myomatosis, leiomyomas).</a> BMJ Clinical Evidence. , (2011).</li><li>Liu, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+epidemiological+profile+of+hysterectomy+in+rural+Chinese+women:+a+population-based+study.">The epidemiological profile of hysterectomy in rural Chinese women: a population-based study.</a> BMJ Open. 7 (6), e015351 (2017).</li><li>Bhave Chittawar, P., Franik, S., Pouwer, A. W., Farquhar, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Minimally+invasive+surgical+techniques+versus+open+myomectomy+for+uterine+fibroids.">Minimally invasive surgical techniques versus open myomectomy for uterine fibroids.</a> Cochrane Database of Systematic Reviews. (10), CD004638 (2014).</li><li>Tinelli, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Angiogenesis+and+Vascularization+of+Uterine+Leiomyoma:+Clinical+Value+of+Pseudocapsule+Containing+Peptides+and+Neurotransmitters.">Angiogenesis and Vascularization of Uterine Leiomyoma: Clinical Value of Pseudocapsule Containing Peptides and Neurotransmitters.</a> Current Protein and Peptide Science. 18 (2), 129-139 (2017).</li><li>Tinelli, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Surgical+management+of+neurovascular+bundle+in+uterine+fibroid+pseudocapsule.">Surgical management of neurovascular bundle in uterine fibroid pseudocapsule.</a> Journal of the Society of Laparoendscopic Surgeons. 16 (1), 119-129 (2012).</li><li>Fagherazzi, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pregnancy+outcome+after+laparoscopic+myomectomy.">Pregnancy outcome after laparoscopic myomectomy.</a> Clinical and Experimental Obstetrics and Gynecology. 41 (4), 375-379 (2014).</li><li>Liu, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+descriptive+analysis+of+the+indications+for+caesarean+section+in+mainland+China.">A descriptive analysis of the indications for caesarean section in mainland China.</a> BMC Pregnancy Childbirth. 14, 410 (2014).</li><li>Weibel, H. S., Jarcevic, R., Gagnon, R., Tulandi, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Perspectives+of+obstetricians+on+labour+and+delivery+after+abdominal+or+laparoscopic+myomectomy.">Perspectives of obstetricians on labour and delivery after abdominal or laparoscopic myomectomy.</a> Journal of Obstetrics &amp; Gynaecology Canada. 36 (2), 128-132 (2014).</li><li>Vandenberghe, G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Nationwide+population-based+cohort+study+of+uterine+rupture+in+Belgium:+results+from+the+Belgian+Obstetric+Surveillance+System.">Nationwide population-based cohort study of uterine rupture in Belgium: results from the Belgian Obstetric Surveillance System.</a> BMJ Open. 6 (5), e010415 (2016).</li><li>You, S. H., Chang, Y. L., Yen, C. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rupture+of+the+scarred+and+unscarred+gravid+uterus:+Outcomes+and+risk+factors+analysis.">Rupture of the scarred and unscarred gravid uterus: Outcomes and risk factors analysis.</a> Taiwan Journal of Obstetrics &amp; Gynecology. 57 (2), 248-254 (2018).</li><li>Wu, X., Jiang, W., Xu, H., Ye, X., Xu, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Characteristics+of+uterine+rupture+after+laparoscopic+surgery+of+the+uterus:+clinical+analysis+of+10+cases+and+literature+review.">Characteristics of uterine rupture after laparoscopic surgery of the uterus: clinical analysis of 10 cases and literature review.</a> Journal of Internal Medicine Research. , (2018).</li></ol>

子宫肌瘤是女性生殖系统中最常见的良性肿瘤, 影响20-25% 的女性1 , 导致异常子宫出血, 反复流产, 盆腔疼痛, 早产, 和不孕在 10-30%的病例2.由于大多数子宫肌瘤患者是无症状的, 实际发病率可能高于公认的 1。子宫肌瘤的管理一般基于各种因素, 包括患者的年龄和症状、子宫肌瘤的大小和位置、患者保存子宫的愿望、妇科医生的技术和经验, 以及?...

子宫肌瘤是妇科手术中最常见的盆腔肿瘤。据估计, 全球发病率约为 20-25% 1.大多数子宫肌瘤是无症状的, 但有时会导致异常的子宫出血、盆腔压力、盆腔疼痛和不良的生殖结局, 从而降低 2,3 的妇女的生活质量。子宫肌瘤的管理取决于个别情况, 包括手术、药物治疗和重访观察4等选择。子宫切除术是治疗子宫肌瘤的重要方法, 是一种预防 3,5 复发的根治性手术。然而, 肌瘤切除术越来越流行, 因为医生越来越关注育龄妇女的生育保持, 特别是在中国两胎政策时代.
正如蒂内利和他的同事们所描述的, 在腹腔镜子宫切除术 (lm)7的过程中, 内脏腹膜被在中线纵向由单折线剪刀或钩针针电极切割, 在一定深度进入肌膜识别假胶囊。伪胶囊通过单极剪刀或钩电极在低瓦数 (30w) 上纵向打开, 以暴露纤维瘤。然后, 纤维瘤螺钉钩住, 在假囊和纤维瘤之间的空间内插入的冲洗器插管的帮助下, 进行温和的摘除。小血管的止血是为了从假囊中释放肌瘤和连接桥的基部。然后将肌膜闭合在单层中, 用于亚粒性纤维瘤, 并将其作为肌内肌瘤的双层。
尽管 lm 在世界范围内得到了广泛的应用, 但这一过程仍存在一些局限性。由于 lm 比剖腹手术技术要求更高, 因此应将其应用于大小相对较小、纤维瘤数量相对较小的病例8,9。腹腔镜手术10切除长度大于8厘米的壁内纤维瘤或12厘米以上的亚血清性纤维瘤仍然是一个巨大的挑战。公布的数据表明, 当应用 lm 去除广泛的韧带肌瘤11时, 输血需要出血和术后血肿显著增加。其他研究人员认为, 过度出血、手术时间延长以及应用停尸期时细胞的潜在传播与 lm12,13有关。据报道, 由于缝合14的技术困难, lm 后子宫突期破裂的风险高于腹部子宫肌瘤切除术.怀孕的安全以后 lm 仍然有争议15。由于子宫肌膜术后愈合对需要临床或根据要求维持生育能力的患者非常重要, 因此 lm 手术需要更适用, 这可以通过减少技术困难和促进手术后子宫愈合。
为了最大限度地减少对患者生育能力的损害, 在这里我们提出了一个修改的子宫肌瘤切除术程序, 囊内旋切程序 (ircp)16。该程序尽可能缩短子宫壁上的切口, 减少了 lm 的技术难度。此外, 它有助于保护纤维和血管的假胶囊, 在子宫切除术后的子宫愈合发挥重要作用, 最终降低术后血肿和子宫破裂的风险, 在随后的怀孕。2012年12月15日, 经过北京大学深圳医院机构评审委员会的审核和批准, 我们开始应用 ircp, 并与传统 lm 进行比较, 对 ircp 的结果进行评估。

<table border="0" cellpadding="0" cellspacing="0" style="width:611px;" width="612">
	<tbody>
		<tr height="42">
			<td height="42" style="height:42px;width:231px;">laparoscopy</td>
			<td style="width:95px;">Stryker Corporation</td>
			<td style="width:119px;">&#160;X 800</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:231px;">morcellator</td>
			<td style="width:95px;">Kangji Medical</td>
			<td style="width:119px;">&#160;KJ-301A</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:231px;">30-cm 1-0 polyglyconate unidirectional barbed thread</td>
			<td style="width:95px;">Covidien</td>
			<td style="width:119px;">V-Loc 180</td>
			<td></td>
		</tr>
	</tbody>
</table>

introduction of intracapsular rotary-cut procedures (ircp): a modified hysteromyomectomy procedures facilitating fertility preservation

子宫肌瘤是女性生殖系统中常见的良性肿瘤。子宫切除术是治疗有症状的子宫肌瘤最有效的方法。对于希望怀孕的患者, 腹腔镜子宫肌囊内切除术 (lm) 是另一种手术选择。虽然 lm 被广泛接受治疗纤维瘤, 但它在技术上要求很高, 有出血过多和缝合困难的风险, 特别是在不寻常位置有大纤维瘤或肿瘤的情况下。因此, 我们开发了一种囊内旋切手术 (ircp), 作为腹腔镜子宫内肌瘤切除术的修改, 目的是最大限度地降低 lm 的风险, 并帮助子宫愈合。摘要介绍了 ircp 的改进之处: 1) 在纤维瘤部位进行切口, 其长度为纤维瘤直径的三分之一至一半, 深度达到纤维瘤表面;2) 将纤维瘤稳定地固定在其假囊内深度 0.5-1 厘米的纤维瘤上, 并在其伪胶囊内进行旋转切割, 同时将其稍微向外拉, 确保不切断纤维瘤的任何部分;3) 重复切拉, 直到纤维瘤的最长尺寸在切口外。多切口是为了最大限度地减少直径和延长纤维瘤的长度。当多切口导致一半的纤维瘤体 "收缩" 时, 纤维瘤被挤压出来的周围肌膜的收缩。对 ircp 结果的评价表明, ircp 组的摘除缝合时间、术中出血和血红蛋白下降时间明显低于 lm 组。在生殖结局方面, ircp 组的足月活产率明显高于 lm 组。然而, 这两组的交付模式没有差异。总之, ircp 通过最大限度地减少对子宫的损害, 保护假囊的肌纤维, 并导致一个较浅的残余腔, 从而减少缝合和减少出血, 显著有利于生育能力的保存。在希望保持生育能力的年轻患者中采用 ircp 是值得的。

2013年至2016年, 对41例子宫肌瘤患者进行了 ircp 治疗, 并对72名患者进行了传统 lm 治疗。lm 组9例 (12.5%) 因大出血、摘除困难或缝合而转为开腹手术, ircp 组所有病例均成功行腹腔镜检查。改性活术组转换为剖腹手术的比例显著高于 (p = 0.025)。除9例转为开腹手术的病例外, ircp 组 (n = 41) 和 lm 组 (n = 63) 患者的平均年龄分别为38.6±5.9年和380.1±6.2 年, 这表明两组之间没有差异 (p = 0.6...

Watch this Scientific Journal Video about Introduction of Intracapsular Rotary-cut Procedures IRCP: A Modified Hysteromyomectomy Procedures Facilitating Fertility Preservation at JoVE.com

Introduction of Intracapsular Rotary-cut Procedures IRCP: A Modified Hysteromyomectomy Procedures Facilitating Fertility Preservation

囊内旋切手术 (ircp) 的介绍: 一种改良子宫肌瘤切除术促进生育保护

在这里, 我们提出了一个协议, 执行囊内旋切手术 (ircp), 一个改进的腹腔镜子宫内切除术, 促进生育保存。

Uterine fibroids are common benign tumors in the female reproductive system. A hysterectomy is the most effective treatment for symptomatic fibroids. For ...

这一程序是为了保护患者的生育能力，防止子宫切除术后怀孕由大，勉强关闭，残余腔和拉愈合的肌瘤引起的子宫破裂的可能性。该程序的主要优点是，它最大限度地减少了对伪胶囊外侧和伪胶囊内血管组织的手术损伤。这种腹内旋转切割程序需要患者和护理需求，尤其是在手术的开始和电气单极刀的应用期间。在开始手术之前，使用标准技术在麻醉患者的下腹部和中腹部建立一个10毫米的脐带端口和两个5毫米的端口，以及一个10毫米的辅助端口。放置所有端口后，仔细检查骨盆以确认肌瘤的大小、数量和位置，并使用 10 毫米注射器将缺血溶液注射到肌瘤周围的肌瘤中。确定肌瘤最突出的一侧的切口位置，并使用30瓦的单极钩电极进行纵向切口，注意长度不超过肌瘤直径的一半。暴露肌瘤表面后，使用腹腔镜钳向外拉肌，露出肌瘤和伪胶囊之间的边界。使用单极电刀在肌瘤的外露部分进行第一次切割，然后用钳子抓住第一个切口的边缘，将肌瘤向外拉。接下来，在肌瘤的四面进行多次长旋转切割，这些切口与从胶囊分离的肌瘤不同级别，部分地与先前切开的衬衫直径重叠。在切割时，将钳子从上一个切口切换到下一次切口，以保持组织向外拉，以方便进一步暴露肌瘤和伪胶囊之间的间隙。使用真空排水去除烟雾，以保持清晰的视场。必要时。当超过一半的肌瘤在切口之外时，肌瘤中的伪胶囊会收缩，将肌瘤挤出腔。伪胶囊应该滑到肌瘤的基座。继续切口，直到肌瘤的基座暴露，可以与伪胶囊隔离。然后使用电烧钳凝固和切断血管，完全切除肌瘤，只留下浅的残余腔。从切口边缘外的五毫米开始，用运行30厘米1-O多糖体、单向刺状缝合的单层关闭空肌瘤腔，以一厘米的增量进行，注意缝合穿过残余腔的底部。然后将 10 毫米端口放大至 15 到 20 毫米，然后用可重复使用的减小器使肌瘤变小。整个过程只有一点出血。在这项临床研究中，在排除了9个转经腹腔镜肌切除术病例后，两组患者的平均年龄在统计学上相似，肌瘤的平均直径也相同。然而，在腹腔内旋转切开手术组，授精和吸血、术中出血和血红蛋白下降的时间都明显低于腹腔镜肌切除术组。腹内旋转切割程序显著减少对子宫的损伤，保护伪胶囊的肌黄体，并留下较浅的残余腔，以便于缝合和愈合肌膜。我们的外展必须保持病人的生育能力。

Research

JoVE Journal

Medicine

Introduction of Intracapsular Rotary-cut Procedures (IRCP): A Modified Hysteromyomectomy Procedures Facilitating Fertility Preservation

Bronchial Thermoplasty:  A Novel Therapeutic Approach to Severe Asthma

支气管Thermoplasty：严重哮喘的一种新的治疗方法

Bronchial thermoplasty is a non-drug procedure for severe persistent asthma that delivers thermal energy to the airway wall in a precisely controlled ...

科研

医学

Remote Magnetic Navigation for Accurate, Real-time Catheter Positioning and Ablation in Cardiac Electrophysiology Procedures

遥控磁导航导管定位准确，实时和心脏电生理消融程序

New remote navigation systems have been developed to improve current limitations of conventional manually guided catheter ablation in complex cardiac ...

Surgical Procedures for a Rat Model of Partial Orthotopic Liver Transplantation with Hepatic Arterial Reconstruction

部分原位肝移植大鼠模型的肝动脉重建的外科手术

Orthotopic liver transplantation (OLT) in rats using a whole or partial graft is an indispensable experimental model for transplantation research, such as ...

A Modified Precipitation Method to Isolate Urinary Exosomes

一种改进沉淀法来隔离尿外来体

Identification of biomarkers that allow early detection of kidney diseases in urine and plasma has been an area of active interest for several years. ...

A Modified Method for Heterotopic Mouse Heart Transplantion

对于异位小鼠心脏移植技术的一种改进方法

Mice are often used as heart transplant donors and recipients in studies of transplant immunology due to the wide range of transgenic mice and reagents ...

Human Skeletal Muscle Biopsy Procedures Using the Modified Bergstr&#246;m Technique

Human Skeletal Muscle Biopsy Procedures Using the Modified BergstrÃƒÆ’Ã‚Â¶m Technique

人骨骼肌活检手术使用修改伯格斯坦技术

The percutaneous biopsy technique enables researchers and clinicians to collect skeletal muscle tissue samples. The technique is safe and highly ...

Improvement of a Closed Chest Porcine Myocardial Infarction Model by Standardization of Tissue and Blood Sampling Procedures

组织和采血程序标准化改善闭合性胸猪心肌梗死模型的研究

Myocardial ischemia reperfusion (I/R) injury contributes to almost half of the necrotic area after myocardial infarction. To date there is no approved ...

Preparation, Procedures and Evaluation of Platelet-Rich Plasma Injection in the Treatment of Knee Osteoarthritis

富血小板血浆注射液治疗膝关节骨关节炎的制备、程序及评价

Knee osteoarthritis (KOA) is one of the most frequently encountered diseases in the orthopedic department. Existing non-surgical treatments have a limited ...

Use of Magnetic Resonance Imaging and Biopsy Data to Guide Sampling Procedures for Prostate Cancer Biobanking

使用磁共振成像和活检数据指导前列腺癌生物库的取样程序

Previous methods for biobanking prostate tissue, following radical prostatectomy, generally involved random sampling. In order to increase efficiency, and ...

Fertility Preservation Through Oocyte Vitrification: Clinical and Laboratory Perspectives

通过卵母细胞维他化保存生育能力：临床和实验室视角

Preserving female fertility is crucial in a multifunctional healthcare system that takes care of patients' future quality of life. Oocyte cryopreservation ...