Name: endoscopy guided photoablation of endometrial cysts using a 980 nm laser with a contact fiber in mares
Uploaded: 2020-07-16T14:30:00
Description: Watch this Scientific Journal Video about Endoscopy Guided Photoablation of Endometrial Cysts using a 980 nm Laser with a Contact Fiber in Mares at JoVE.com

作者要感谢帕斯卡尔·勒琼先生在所有程序中给予的技术支持。

所提交的协议用于在马医院展示的母马，并遵循机构动物护理指南。
注：在麻醉前进行子宫内膜囊肿光解：因此在7月底或8月观察到的热量似乎最可靠。不要在繁殖季节太晚执行此程序，因为它可以限制可用于治疗潜在子宫内膜炎的雌膜数量。
1. 在前一次埃斯特鲁斯期间
<ol><li>对母马进行完整的繁殖健全性检查，包括子宫内膜活检1（ ...

<ol>
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S., Zent, W., Holder, R., Asbury, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasonography+as+an+adjunct+to+pregnancy+assessments+in+the+mare.">Ultrasonography as an adjunct to pregnancy assessments in the mare.</a> Journal of the American Veterinary Medical Association. 184 (3), 328-334 (1984).</li><li>LeBlanc, M., Mc Kinnon, A. O., Mc Kinnon, A. O., Squires, E. L., Vaala, W. E., Varner, D. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Equine Reproduction Vol. 2. , 2620-2642 (2011).</li><li>van Ittersum, A. 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子宫内膜囊肿的子宫镜检查和激光光化是减少母马中大的发光囊肿的简单程序，如前所述14。从技术上讲，当在雌雄母马上执行时，此方法会得到改进。与空气填充和执行过程中的连续吸入相比，使用无菌盐水溶液充气子宫可提高能见度。 小腹囊肿（<10毫米）更难到达和治疗。此外，如果激光治疗时间延长，治疗这些小囊肿可能导致子宫内膜和骨髓穿孔。然而，他们很少干扰胚?...

母马的子宫内膜囊肿是肯尼1号在七十年代描述的组织病理学。在八十年代末期，使用子宫镜检查和超声波检查导致他们的临床描述，并有助于了解它们对生育力的影响2，3，4，5。
在早期阶段，子宫内膜囊肿与子宫内膜的退化有关，现在称为子宫内膜1，3，4，6，7，8，目前人们承认，小（<1厘米）囊肿与子宫内膜腺纤维化有关，而较大的囊肿与淋巴扩张6有关.这些大囊肿最有可能在第6.5天至第17天之间干扰马胚胎移植，从而通过损害母体识别1、3、4、6、8来降低生育能力。子宫内膜囊肿也可能干扰早孕诊断，特别是如果它们是圆形的，其大小与胚胎囊泡3、4、6、9相似（见图1）。因此，他们可以通过推迟第一次胚胎超声波检查和双胞胎妊娠评估（见图2）来增加两次授精之间的间隔。子宫内膜囊肿也可能机械地干扰子宫厕所期间的液体收集，以治疗子宫内膜炎或收集胚胎。因此，子宫内膜囊肿对观察到的母马的生育能力有影响，在育种场有潜在的经济后果。
除了尝试治疗基础子宫内膜10，内窥镜引导的囊肿焦点治疗已经提出。电外科烧灼被描述，但热暴露可能会伤害囊肿11周围的子宫内膜。只有当分泌结构在穿刺12时不再活跃时，囊肿的吸气才有效。激光照射与980纳米二极管激光与接触纤维似乎显示较小的后续子宫内膜疤痕6，13。激光设备和程序6的改进，现在使我们能够提出这种安全和有效的技术，在马匹临床实践。但是，必须告知母马所有者此选项的局限性。囊肿的光化将增加一些母马的胚胎识别，在某些情况下将推进妊娠诊断，并可能限制子宫内膜囊肿对子宫厕所的负面机械影响，以治疗子宫内膜炎或收集胚胎。然而，它永远不会治疗伴随的根本子宫内膜异位症或子宫内膜炎。
本报告旨在描述在母马中执行子宫镜导引二极管激光囊肿消融的有效程序。临床应用的准备和程序将实际描述。

<table border="0" cellpadding="0" cellspacing="0" style="width:664px;" width="663">
	<colgroup>
		<col />
		<col />
		<col />
		<col />
	</colgroup>
	<tbody>
		<tr height="21">
			<td height="21" style="height:21px;width:214px;">Butorphanol</td>
			<td style="width:121px;">Animedica</td>
			<td style="width:161px;">Morphasol 10 mg/mL</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:214px;">Detomidine</td>
			<td style="width:121px;">Dechra</td>
			<td style="width:161px;">Domidine 10 mg/mL</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:214px;">Endoscope</td>
			<td style="width:121px;">Olympus</td>
			<td style="width:161px;">Vet 170-10 SN2012729</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:214px;">Endoscope Vid&#233;o Tower</td>
			<td style="width:121px;">Olympus</td>
			<td style="width:161px;">CLE-E &#38; CV-E</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:214px;">Laser device</td>
			<td style="width:121px;">Wuhan Giga Optronics</td>
			<td style="width:161px;">Velas II-60B GA19-V3186</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:214px;">NaCl 0.9%</td>
			<td style="width:121px;">Baxter</td>
			<td style="width:161px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:214px;">P&#233;nicilline-proca&#239;ne</td>
			<td style="width:121px;">Kela</td>
			<td style="width:161px;">PENI-Kel 300.00 UI/ml</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:214px;">Ultrasonography</td>
			<td style="width:121px;">Aloka</td>
			<td style="width:161px;">Aloka 500 &#38; 5mHz transrectal probe</td>
			<td></td>
		</tr>
	</tbody>
</table>

endoscopy guided photoablation of endometrial cysts using a 980 nm laser with a contact fiber in mares

在母体中，子宫内膜囊肿与子宫内膜异位症有关，可导致产妇识别失败或妥协和延迟妊娠诊断。历史治疗具有侵入性，对子宫内膜有不良影响。歇斯底里引导激光治疗是简单和有效的子宫内膜囊肿切除，没有对子宫内膜的有害影响。
子宫内窥镜长110厘米，宽1.0厘米，在外阴清洗后，通过母马的开放子宫颈进行无菌引入。子宫缓慢地注入小于1升的生理溶液，激光纤维插入内窥镜的活检管中。然后用 980 nm 二极管激光烧灼，接触纤维设置为 20+20122 5W，以连续模式。每个囊肿被刺穿，直到囊肿完全失效和纤维周围的囊肿壁收缩。子宫熔岩与无菌盐水溶液在手术后直接进行，并作为非炎症液体可以观察到一两天。
此过程简单且快速执行，没有明显的有害效果。囊肿切除术使超声波妊娠诊断更容易，在某些情况下，可以在6.5至17日之间恢复子宫角的适当胚胎迁移。然而，这种治疗并不能改善与子宫内膜异位症相关的基本组织病变。在进行此程序之前，应向育种者明确表达这些考虑。

手术是在有直径超过15毫米的囊肿的母马身上进行的。然而，如果其他较小的囊肿也存在，尝试其他囊肿的光消融。一般来说，这些大囊肿是在分叉或角的基础。然而，其中一些在子宫内，并受到同等对待。
根据我们的经验，内膜囊肿很容易与内窥镜本地化。此外，在盐水溶液中执行此程序可提高子宫内的可见性：它避免蒸汽的排放、子宫内膜粘液和淋巴液混合导致的泡沫产...

Watch this Scientific Journal Video about Endoscopy Guided Photoablation of Endometrial Cysts using a 980 nm Laser with a Contact Fiber in Mares at JoVE.com

Endoscopy Guided Photoablation of Endometrial Cysts using a 980 nm Laser with a Contact Fiber in Mares

本报告的目的是利用内窥镜激光装置描述母马子宫内膜囊肿的光消融，并讨论这种处理低生育率问题的新方法的兴趣和局限性。

内窥镜引导光活内膜囊肿使用 980 nm 激光与接触纤维在马雷斯

In mares, endometrial cysts are associated with endometriosis and can cause maternal recognition failure or compromise and delay pregnancy diagnoses. ...

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