ISMIVS Newsletter March&April, 2021 Newsletter ISMIVS

ISMIVS Newsletter March&April, 2021

Newsletter 2021 March & April

2021年3月及4月简报

About Us 国际微无创医学会简介

The International Society of Minimally Invasive and Virtual Surgery (ISMIVS, previously known as International Society of Minimally Invasive and Noninvasive Medicine) was founded in July 2013 at the gala of the 1st Yangtze International Summit of Minimally Invasive and Noninvasive Medicine in Chongqing, China. ISMIVS envisions to accelerating the progress in minimally invasive and noninvasive medicine by promoting research, education, communication, and international collaboration.
国际微无创医学会（ISMIVS）是在 2013 年 7 月在中国重庆召开的第一届国际微无创医学长江高峰论坛上宣布成立的，旨在通过学术研究、教育、交流以及国际合作加快微无创医学的发展。

Become a member 注册成为会员 >

The Personality in the Medical Education World 医学教育界的大人物

From the July issue of our ISMIVS Newsletter, we would like to introduce some pioneers in the field of minimally-invasive and noninvasive medicine. They are not only prestigious in their field but also willing to share their experience and ideas with younger doctors, hence making a great contribution to medical education. In this issue, we are going to introduce Prof. Prashant Mangeshikar from India.
从 2020 年 7 月刊开始，国际微无创医学会将为大家介绍微无创医学领域的一些领军人物。他们不仅在各自的领域享负盛名，而且非常乐意与年轻医生分享他们的经验、理念和想法，从而为医学教育做出了巨大的贡献。本期月刊要介绍的医学教育界的大人物是来自印度的普拉尚特•曼盖什卡（Prashant Mangeshikar）教授。

Prof. Prashant Mangeshikar
普拉尚特•曼盖什卡教授

Director of Global Development of International Society of Neuropelveology (ISON)
Past President of International Society of Gynecological Endoscopists (ISGE)

Past President of Indian Association of Gynecological Endoscopists (IAGE)

Founding Board Member of Asia-Pacific Association for Gynecologic Endoscopy and Minimally Invasive Therapy (APAGE)
国际盆腔神经学会（ISON）全球发展主任
国际妇科内镜医师学会（ISGE）前主席
印度妇科内镜医师学会（IAGE）前主席
亚太妇产科内视镜暨微创治疗医学会（APAGE）创始理事

Prof. Mangeshikar has dedicated more than 30 years of his life in the OB-GYN field with immense experience in laparoscopic myomectomy, total laparoscopic hysterectomy, endometriosis, laparoscopic surgery for pelvic organ prolapse and minimal access gynecological surgery. In 2003, together with a group of committed endoscopists from the Asia-Pacific region, he founded the Asia-Pacific Association for Gynecologic Endoscopy and Minimally Invasive Therapy (APAGE), which represents over 15 associations in the gynecologic field worldwide and provides various scientific and educational activities for doctors. Prof. Mangeshikar has devoted in the innovations in laparoscopic instrumentation, training gynecologists across the world in minimally access gynecological surgery.

曼盖什卡教授从事妇产科临床工作 30 余年，在腹腔镜子宫肌瘤剔除术、腹腔镜子宫全切术、子宫内膜异位症、腹腔镜下盆腔器官脱垂手术、微创妇科手术等方面有着丰富的经验。2003 年，与亚太其他几位致力于腔镜发展的专家一起创立了亚太妇产科内视镜暨微创治疗医学会（APAGE）。该学会代表了全球15余个妇科协会，为医生提供各种科学和教育培训活动。曼盖什卡教授致力于腹腔镜设备的创新、培训全球妇科医生学习微创妇科手术。

Below are two lectures given by Prof. Mangeshikar：

以下是Prof. Mangeshikar教授的两个讲课视频:
1.The skill in laparoscopic myomectomy
腹腔镜肌瘤剔除术的技巧
https://m.youtube.com/watch?v=beSpMtelQ6k
2.Total laparoscopic hysterectomy in women with large uterine fibroids
腹腔镜下子宫全切术治疗巨大子宫肌瘤
https://m.youtube.com/watch?v=1ahJT17LsCQ

News 新闻

IWD-HIFU 2021: the World's Second Multicenter Telemedicine Womb-Preserving Campaign
2021 国际妇女节公益活动: 第二届全球多中心远程协同手术保子宫公益行动

To continue the philanthropic event of IWD-HIFU 2020 and the care for women's health, ISMIVS and NERCUM organized IWD-HIFU 2021, the World's Second Multicenter Telemedicine Womb-Preserving Campaign, which was held on March 2, 2021 and themed on Focusing on Women's Health and Inspiring the World with Warmth. 128 HIFU Centers participated and provided noninvasive uterus-sparing HIFU treatment for more than 120 patients with uterine fibroids and/or adenomyosis. It was broadcast live by NERCUM and witnessed by news media.
为了延续 2020 年发起的国际妇女节公益活动，延续对女性的关爱，2021 年 3 月 2 日，国际微无创医学会联合超声医疗国家工程研究中心举办“聚焦女性健康，温暖牵动全球”第二届全球多中心远程协同手术保子宫公益行动。全球 128 家医院的海扶®微无创治疗中心应用聚焦超声消融技术为 120 余名子宫肌瘤和/或子宫腺肌症患者提供无创保子宫治疗。超声医疗国家工程研究中心对 120 余台手术进行直播，主流媒体参与见证。

Meanwhile, a 30-minute Summit Meeting on Noninvasive Uterus-Sparing Treatment convened, inviting six world leading experts to talk about the impacts of the COVID-19 on global women's health and the countermeasures we've taken, the special features of HIFU procedures and their perspective on the future of minimally-invasive and noninvasive medicine and therapies for women's health.
同时，为时 30 分钟的无创伤保子宫高峰对话在活动现场进行，邀请到 6 位国际专家探讨新冠肺炎对全球女性健康的影响以及采取的应对措施、聚焦超声消融治疗的优势以及对守护女性健康的微无创技术和医学的发展展望。

Prof Gian Carlo Di Renzo, Past Secretary-General of FIGO, said that “although over 120 million people have been infected in the world, if we look maternal fetal medicine, this is an area which has not been touched so much, young age and hormone may be the reasons. Very few pregnant women died due to COVID-19 but most of the death are caused by lack of appropriate care. The transmission of the virus is very unlikely to the fetus.” And then he shared his treatment experience.
国际妇产科联盟（FIGO）前秘书长吉安·卡洛·迪·伦佐教授说道，虽然全球有 1.2 亿人感染新冠病毒，但仔细一看会发现母胎医学领域没有受到太多波及，也许是由于年轻、激素旺盛，极少孕产妇是因感染新冠病毒而病逝，但绝大多数的死亡是因缺乏适当护理而导致的（新冠疫情期间，大量医疗资源被调用，孕产妇没有得到适当护理）。婴儿感染新冠病毒的可能性很小。随后，他也分享了自己的治疗经验。

Professor Philippe Descamps, FIGO Executive Board Member, shared the impact of the pandemic on obstetric and gynecological surgery. The pandemic has posed a challenge to surgery, but fortunately, academic societies have provided guidelines on the arrangement of priority surgeries when facing emergency surgery and cancer patients. Besides, in order to prevent surgeons from infection, a series of measures, surgical habits and the selection of surgical modalities have been established against the backdrop of the pandemic and thsese may be continued for the post-pandemic era.
FIGO 执行委员会成员 Philippe Descamps 教授分享了疫情对妇产科手术的影响。疫情给手术造成了挑战，好在各大学会有给出指导方案，例如在面对紧急手术、肿瘤患者时如何安排手术的先后顺序。此外，为预防手术医生感染，一系列预防措施、手术习惯、手术方式的选择在疫情下建立，并且可能会一直延续到后疫情时代。

Prof. David Cranston, President of International Society of Minimally Invasive and Virtual Surgery (ISMIVS), said that the HIFU treatment number in 2020 was extremely impressive, for emergency and selective surgeries were slashed in many European countries with longer waiting periods due to the pandemic. The HIFU treatment number in 2020 highlighted the advantages of HIFU therapies, that is, contact-free (very safe), no cutting-open (noninvasive), no bleeding, no need of anaesthesia, only sedation and analgesia required, which would reduce the risk of transmission and infection of COVID-19. He believed that more and more people would see the advantages of noninvasive HIFU therapy as being repeatable and fertility-preserving.
国际微无创医学会主席 David Cranston 教授讲到，聚焦超声消融治疗 2020 年的治疗量很了不起, 欧洲很多国家在疫情状况下都面临手术等候期加长、手术取消增多的问题。聚焦超声消融治疗的优势就在于无接触（安全）、不开刀（无创）、不需要麻醉，只需要镇静镇痛，也就不需要常规手术室，这就降低了新冠传播风险，这一点非常好，相信在疫情中更多人会看到无创手术的优势——可以重复、保护患者的生育功能。

Prof. Zhibiao Wang, Director of National Engineering Research Center of Ultrasound Medicine (NERCUM) of China, said that the HIFU treatment number over the past 21 years showed that the HIFU ablation technology and its commercialization were developing well and rapidly, especially in the treatment of benign uterine diseases. HIFU procedures were not badly affected by the pandemic with only a small decline in the HIFU cases in 2020 compared to 2019, which highlighted the advantages of HIFU treatment. However, the number of HIFU treatments stood no comparison with that of conventional treatment modalitiesl. He hoped to strengthen cooperation with global institutions in the future and work together to benefit more women with this non-invasive technology so as to avoid surgical injury and even the removal of their uterus.
超声医疗国家工程研究中心主任王智彪教授表示，近 21 年的聚焦超声消融治疗数据显示该技术、市场日趋成熟，其中以妇科良性肿瘤为主。而且在疫情状况下，与 2019 年相比，2020 年的治疗量下降幅度不大，这凸显了无创手术的优势。但是比起传统手术，聚焦超声消融的治疗量还很小，他希望未来能加强和全球机构的合作，共同努力，让更多的女性可以接受这项无创技术的治疗，免受治疗本身的创伤甚至是子宫被切除。

Prof. Rudy Leon De Wilde, Past President & Director of the European Society of Gynecological Endoscopy (ESGE), reviewed the surgical development from major open surgery to minimally invasive endoscopic surgery. He said that endoscopic surgery still caused surgical injury although it was minimally-invasive and significantly reduced the surgical injury. In his opinion, the increasing maturity of HIFU treatment in gynecology was signaling the possibility and potential of noninvasive treatment of gynecological diseases. And therefore, ESGE has established a Working Group on “Non-surgical ablative therapy of benign uterine disease” to promote the noninvasive technology.
欧洲妇科内窥镜学会（ESGE）前主席 Rudy Leon de Wilde 教授回顾了妇科手术从开腹大创伤发展到以腔镜为代表的微创，大大减少了手术带来的创伤，但是再小的伤害仍然是伤害。HIFU 在妇科领域应用日渐成熟，标志着无创治疗妇科疾病的可能性和前景。由此，ESGE 成立了专门的工作组，致力于这项新治疗技术在全球的推广。

Prof. Jinghe Lang, President of Chinese Obstetricians and Gynecologists Association (COGA), China, gave a presentation on the development of minimally invasive and noninvasive medicine and humanities from the perspective of the management of uterine fibroids. He believed that medicine was a people-oriented discipline and that patients’ organs and functions should be protected to the greatest extent. Uterine fibroids are the tumors that best embody the "four criteria" of treatment: standardization, individualization, minimal invasion and humanization. Although the management of uterine fibroids are being constantly optimized, the annual number of hysterectomies is still shocking. Prof. Lang called on doctors not to stick to one treatment modality, to think more, consider more alternative treatments and provide the best care for patients with womb-preserving modalities that best fit them. He hoped to see more extensive dissemination of noninvasive technologies featured by HIFU in the future.
中国医师协会妇产科分会会长、中国工程院院士郎景和教授从子宫肌瘤的治疗来谈微无创医学和人文的发展。他认为医学应该以人为本，在治疗的过程中尽最大程度保护患者的器官和功能。子宫肌瘤是最能体现治疗“四化”的肿瘤——“规范化”、“个体化”、“微创化”、“人性化”。子宫肌瘤的治疗方式也在不断优化，但全球子宫切除的数量仍然惊人，他呼吁医生不要固守一种治疗方式，多一些思考、多一些选择，适合的才是最好的，希望未来聚焦超声治疗技术能作为无创技术的代表传播得更广泛。

The Women Care Move of SUPER-MOM Philanthropic Program of China Women's Development Foundation (CWDF) also initiated a non-profit activity at IWD-HIFU 2021, launching Sister Card to 100,000 women in China in 2021, to facilitate the assistance to prevention and treatment of major health-threatening cancers in the chest and the uterus, as well as diagnosis and treatment of major quality-of-life-influencing benign uterine diseases, such as fibroids and adenomyosis.
中国妇女发展基金会超仁妈妈公益项目姐妹行动也在 2021 国际妇女节公益活动中发起公益行动，2021 年向中国 10 万名女性发放姐妹卡，推动中国女性在乳腺、子宫等影响女性健康的重大癌症防治以及子宫肌瘤、子宫腺肌症等严重影响女性生活质量的良性疾病的诊疗协助。

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PSTHIFUOG & ISMIVS Webinar: Application of HIFU in obstetrics and gynecology
国际微无创医学会（ISMIVS）&菲律宾妇产科高强度聚焦超声治疗学会（PSTHIFUOG）联合会议：HIFU在妇产科的应用

Co-organized by Philippine Society of Therapeutic High Intensity Focused Ultrasound in Obstetrics and Gynecology (PSTHIFUOG) and ISMIVS, a webinar themed on "Application of HIFU in obstetrics and gynecology" was held on March 19, 2021.
2021 年 3 月 19 日，国际微无创医学会（ISMIVS）联合菲律宾妇产科高强度聚焦超声治疗学会（PSTHIFUOG）共同举办主题为“HIFU 在妇产科的应用”线上会议。

Prof. Aixingzi Aili from China talked about HIFU Experience in Shanghai First Maternity and Infant Hospital (SFMIH), China. SFMIH has provided HIFU treatment service since August, 2015. By June 2020, it has performed 1550 HIFU ablation procedures, ranking the first in Shanghai in terms of the cumulative total number of HIFU cases. Currently, it performs around 500 HIFU treatments every year, mainly on the management of uterine fibroids and adenomyosis. Its research focuses on endometriosis and adenomyosis, whose classification is very important for HIFU treatment. Besides, Prof. Aili also shared her combined therapy of HIFU, GnRH-a and LNG-IUS for the treatment of adenomyosis. Such combined therapy has been proved safe, effective and efficient, which can lower the risk of requiring hysterectomy and improve patients' quality of life, especially for those with localized adenomyosis.
来自中国的艾星子·艾里教授分享了上海市第一妇婴保健院的 HIFU 治疗经验。上海一妇婴 2015 年 8 月开始开展 HIFU 临床治疗，截至 2020 年 6 月，该院 HIFU 消融累计治疗量达 1550 例，位居上海第一。目前治疗量每年保持在 500 例左右，临床治疗适应症主要为子宫肌瘤和腺肌症。上海一妇婴主要开展 HIFU 治疗子宫内膜异位症和子宫腺肌症的临床研究。对 HIFU 治疗而言，腺肌症的分型很重要。艾里教授分享了 HIFU 联合 GnRH-a、LNG-IUS 治疗子宫腺肌症的经验。该联合疗法已被证明安全、有效且高效，既可降低需要进行子宫全切的风险，又可以提高患者的生活质量，特别是局限性子宫腺肌症患者的生活质量。
Dr. Raymond Setzen from South Africa shared his experience of HIFU treatment in the large teaching hospital of Chris Hani Baragwanath Hospital in Johannesburg serving for black people. He has treated 485 cases of uterine fibroids with HIFU. The healthcare benefits of HIFU: reduces burden on healthcare system, including shorter hospital stay, freeing up theaters, lower running costs, decreasing exposure to HIV, and decreasing dependence on blood. Benefits for patients: preserves the uterus and retains fertility; noninvasive so it can decrease recovery period, quicker return to work. The patients treated in his experience had higher weight (mean 79kg, range 43-115kg) and thicker abdominal wall (mean 49mm, range 33.3-64.7mm) comparing with other countries. The major adverse events were: 2 cases of 1st degree skin burn, 2 cases of nerve injury which restored spontaneously, no bowel injury, and no nerve injury. The Quality of Life Questionnaire showed that the average score increased from around 35 to almost 75 within 24 months after treatment, and for symptom severity score it dropped from 60 to below 20. The shrinkage rate found in follow-up after 1, 3, 6 and 12 months were 31%, 52%, 61%, 73% respectively. Fertility success: 16 cases, including 8 currently pregnant, 1 vaginal delivery, 7 term Caesarean deliveries. Dr. Raymond concluded that HIFU was safe and effective alternative treatment for UF in black women, resulted in promising, great potential for improving women's health, and alleviated burden on his hospital.
来自南非的雷蒙·赛森（Raymond Setzen）医生分享了其在约翰内斯堡 Chris Hani Baragwanath 医院为黑人患者服务的大型公立教学医院内开展HIFU治疗的经验。赛森医生已经应用 HIFU 治疗 485 例子宫肌瘤患者。他认为，HIFU 给医疗保健带来的益处：减少了医疗保健系统的负担，包括住院时间更短、减少手术室的使用、经营成本更低、降低 HIV 感染风险、降低对血源的需求。HIFU 对患者的好处：保子宫从而保留了患者的生育能力；无创治疗，因此，术后恢复时间缩短，患者能够更快投身工作。与其他国家的患者相比，赛森医生的患者其体重更重（平均值为 79 KG，范围为 43-115 kg），腹壁更厚（平均值为 49 mm，范围为 33.3-64.7 mm）。HIFU治疗子宫肌瘤的主要副作用：有 2 例一级皮肤烫伤，2 例神经受损后自行恢复，无肠道损伤，无神经损伤。患者生活质量问卷调查表明：术后两年以内，患者生活质量平均分从 35 分左右上升到了将近 75 分，症状评分从 60 分下降到不足 20 分。术后 1 个月、3 个月、6 个月以及12 个月后进行的随访中显示肌瘤收缩率分别为31%、52%、61%、73%。生育成功病例：共16例患者，8例处于妊娠期、1例阴道分娩、7例足月剖腹产。赛森医生表示，HIFU 治疗黑人女性子宫肌瘤安全有效，对改善女性健康，缓解医院压力具有良好前景。
Dr. Filomena San Juan from Philippines talked on comparison of HIFU and different modalities in the treatment outcome for adenomyosis and uterine myoma. In her opinion, the development trend of modern medicine is from open surgery to minimally invasive therapy and then to noninvasive therapy. She shared her conclusion from the analysis of 12 articles:
来自菲律宾的菲洛梅娜·圣胡安（Filomena San Juan，圣胡安）医生对 HIFU 和其他方式治疗子宫腺肌症和子宫肌瘤进行了比较。她认为现代医学的发展趋势是从大创手术到微创治疗再到无创治疗。通过对12篇文章的分析，她得出以下结论：
In the treatment of fibroids,
Adverse effects are infrequent in HIFU;
Hospital stay is shorter and return to work is quiker;
USgHIFU has lowest cost of procedure;
Reintervention rate in HIFU is small;
HIFU is safe, effective, cost-effective and affords speedy recovery;
Long term clinical outcome of USgHIFU is better than uterine-sparing surgery and maybe safer;
USgHIFU shortens time to pregnancy, pregnancy ratio are similar compare to laparoscopic myomectomy (LM);
Cesarean section rates, placenta previa and increta rates, uterine rupture rates are higher in LM;
Regarding to the comparison of productive outcome of patients with adenomyosis and infertility treated with USgHIFU or LM, the results have no significant difference.
在子宫肌瘤的治疗方面：
HIFU 治疗的副作用比较少见；
住院时间更短、更快复工；
超声引导的 HIFU 治疗费用最低；
HIFU 的二次干预率低；
HIFU 是一种安全、有效、性价比高、恢复快的治疗方式；
超声引导的 HIFU 治疗其长期临床结果优于保子宫的手术方式，可能也更安全；
超声引导的 HIFU 治疗后备孕时间更短、妊娠率和腔镜剔除术相近；
腔镜剔除术组剖宫产率、前置胎盘发生率、胎盘植入发生率、子宫破裂率较高；
超声引导的 HIFU 或者腔镜剔除术治疗子宫腺肌症和不孕患者后的生殖结局没有显著差异。

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SOGON & ESGE-WG & ISMIVS Webinar: Non Surgical Treatment of Uterine Disorders
国际微无创医学会（ISMIVS）、尼日利亚妇产科学会（SOGON）、欧洲妇科内镜协会
非手术消融良性子宫疾病工作组（ESGE-WG）联合会议：非手术治疗子宫疾病

Co-organized by the Society of Gynaecology and Obstetrics of Nigeria (SOGON), the Working Group on Non-Surgical Ablative Therapy of Benign Uterine Disease of the European Society for Gynecological Endoscopy (ESGE-WG), and the International Society of Minimally Invasive and Virtual Surgery (ISMIVS), a webinar themed on "Non Surgical Treatment of Uterine Disorders" was held on April 24, 2021.
2021 年 4 月 24 日，国际微无创医学会（ISMIVS）联合尼日利亚妇产科学会（SOGON）、欧洲妇科内镜协会非手术消融良性子宫疾病工作组（ESGE-WG）共同举办主题为“非手术治疗子宫疾病”线上会议。

Prof Hugo C. Verhoeven started his talk by sharing his experience how he got to know High Intensity Focused Ultrasound(HIFU) and his ideas on HIFU treatment of uterine fibroids, adenomyosis and influence on fertility. His take-home messages were: HIFU treatment does not increase the complication rate during pregnancy and delivery, especially no increase of uterine rupture; Infertility patients with adenomyosis, conceive spontaneously after HIFU treatment and deliver term babies; HIFU is a safe treatment option for fertility patients.
雨果·C·维霍文（Hugo C. Verhoeven）教授首先介绍了他是如何了解到高强度聚焦超声技术（HIFU）以及他对 HIFU 治疗子宫肌瘤、子宫腺肌症的看法及其对生育的影响。他的讲课要点是：HIFU 治疗不会增加怀孕和生产过程中的并发症发生率，尤其是不会增加子宫破裂的风险；患有子宫腺肌症的不孕患者在 HIFU 治疗后自然怀孕并足月生产；HIFU 对有生育需求的患者而言是一种安全的治疗选择。
Prof. Christopher O. Aimakhu gave a lecture titled “Drug Treatment for Fibroids and Adenomyosis”about the current drugs available and their advantages and disadvantages. He concluded that medical management of uterine fibroids may provide symptomatic relief of the uterine fibroids-related symptoms along with the opportunity to maintain fertility; that currently GnRH agonists and SPRMs were the most effective medical therapies, with the most evidence to support their reduction of fibroids and symptomatic improvement in menstrual bleeding; that the choice of treatment depended on the patient's personal treatment goals, as well as efficacy and need for repeated interventions; and that for treatment of adenomyosis, it should be tailored to the specific symptom or request of the individual patients.
克里斯托弗·O·艾马库（Christopher O. Aimakhu）教授发表了题为“药物治疗子宫肌瘤和腺肌症”的演讲，分享了目前可用的药物及其优劣势，并总结道，药物管理子宫肌瘤可能可以缓解相关症状同时保留生育功能；目前，GnRH-a和 SPRM 是最有效的药物，大部分证据表明可以缩小肌瘤并改善经血症状；治疗方式的选择取决于病人的治疗目的、反复干预的有效性和必要性；对于子宫腺肌症的治疗，需要对症并结合患者个体的需求来定制治疗方案。
Dr. Hammed Ninalowo talked on “Uterine Fibroids and Interventional Radiology Management”, targeted on uterine fibroid embolization (UFE). In his opinion, UFE had minimal complication rate and proven effectiveness in over 30 years and quick recovery. He shared how the procedure was done. Results showed that success rate for improving symptoms was approximately 85-95% and there was on average a 50-70% of uterine and dominant fibroid volume reduction in 3-6 months. The possible complications included post embolization syndrome which were self limiting; bleeding at access site and endometrial infection were rare; vaginal discharge, fibroids shedding or expulsion depended on location of fibroids; chances of a complication leading to hysterectomy was ＜0.5%. Studies showed that the probability of successful pregnancy with live birth at 1 and 2 years was 24.4% and 36.7% respectively.
哈米德·尼纳罗沃（Hammed Ninalowo）医生介绍了“子宫肌瘤及介入放射治疗”，主要介绍的是子宫肌瘤栓塞术（UFE）。尼纳罗沃医生认为 UFE 的并发症发生率低，30 多年来已证明其有效性且恢复快。他分享了 UFE 的治疗过程。治疗结果显示，症状缓解的成功率可以达到 85-95%，而且术后 3-6 个月子宫和主要肌瘤的平均缩小率可以达到 50-70%。可能发生的并发症包括栓塞后综合征但都是自限性的；栓塞部位出血及子宫内膜感染很少见；是否出现阴道排液、肌瘤脱落或排出取决于肌瘤的位置；因并发症导致子宫全切的概率低于 0.5%。研究表明，术后 1 年及2 年内怀孕成功且活产的概率分别为 24.4% 和 36.7%。
Dr. Nuria Pons Serra talked on “HIFU and Fertility” and shared her HIFU experience in the University Hospital Mutua de Terrassa (HUMT), Barcelona, Spain, which showed that the adverse events rate of HIFU was around 10% which were mainly skin burns, hematuria, vaginal bleeding etc. They saw 42 pregnancies including 41 singletons and 1 pair of twins. 90% got full-term deliveries. Based on their experience and analysis of studies, no uterine rupture occurred after HIFU, and the pregnancy rate was higher than laparoscopic surgery.
努莉亚·庞斯·塞拉（Nuria Pons Serra）医生发表了题为“HIFU 和生育”的演讲，并分享了其在西班牙巴塞罗那特拉萨大学医院的 HIFU 临床治疗经验：HIFU 的副反应发生率约为 10%，主要是皮肤烫伤、血尿、阴道流血等；42 例患者妊娠，包括了 41 例单胎妊娠及 1 例双胎妊娠，其中 90%为足月分娩。根据他们的经验和研究分析，HIFU 术后没有出现子宫破裂，妊娠率高于腔镜手术。

Notice通知

The 5th Yangtze International Summit of Minimally-Invasive and Noninvasive Medicine: Postponed to 2022
第五届国际微无创医学长江高峰论坛：推迟至 2022 年举行

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ISMIVS launching its online training program
国际微无创医学会培训课程上线中

The International Society of Minimally Invasive and Virtual Surgery is pleased to announce the availability of a series of online training courses on the clinical application of noninvasive focused ultrasound therapy. A variety of courses related with ultrasound-guided high intensity focused ultrasound (HIFU) ablation of uterine fibroids will enlighten doctors about the physics and biological effect of HIFU, case screening, clinical protocol, anesthesia plan, nursing care, etc. In the meantime, more courses on focused ultrasound therapy of other diseases will be uploaded in the future, please follow us on www.ismivs.org for what you are interested in.
国际微无创医学会很高兴向大家宣布：我们的线上培训课程开始正式上线。课程将涵盖超声引导的高强度聚焦超声（HIFU）消融子宫肌瘤的物理学基础和生物学效应、病例筛选、临床方案、麻醉方案以及临床护理等。同时更多聚焦超声无创治疗其他疾病的课程将陆续上线，欲了解更多，请关注我们的官方网站 www.ismivs.org
The training courses are accessible only to part of ISMIVS members.
培训课程仅向部分国际微无创医学会会员开放。

Nursing for HIFU Treatment of Uterine Fibroids/Adenomyosis
HIFU 治疗子宫肌瘤和子宫腺肌证的护理

This lecture gives a detailed introduction to the whole nursing process of HIFU treatment, which involves five parts: 1. preoperative preparation, 2. intraoperative nursing care, 3. postoperative nursing care, 4. post-discharge guidance, and 5. common postoperative responses and corresponding management.
本课程详尽介绍了 HIFU 治疗的护理全过程，包括 5 个阶段：术前准备、术中护理、术后护理、出院后指导和术后常见反应及相应处理措施。

Become a member >

申请成为会员 >

To apply for the training courses,
please contact the ISMIVS Secretariat
jennyzhang@isminim.org
申请线上课程学习，
请联系国际微无创医学会秘书处
jennyzhang@isminim.org

Tech Update 微无创技术新进展

Gynaecological surgeries in the era of COVID-19 pandemic: a prospective study
COVID-19 大流行病期间的妇科手术：一项前瞻性研究

This study aimed to determine the types of gynecological surgeries performed, difficulties encountered, and their outcomes in the setting of the COVID-19 pandemic. The authors concluded that gynecological surgeries could continue to be safely performed with all precautions in place against COVID-19 infection and related morbidities.
本文旨在确定 COVID-19 大流行病期间开展的妇科手术类型、遇到的困难以及手术结局。作者得出结论：妇科手术仍可继续安全进行，前提是要采取 COVID-19 感染及相关疾病的预防措施。
The following measures were observed as precautions during surgery:
经临床观察，以下措施为手术过程中的预防措施：
• All surgeries were conducted by an experienced surgeon to ensure that all precautions were taken and to minimize the duration of surgery.
• 所有手术均由一位经验丰富的外科医生实施，以确保采取所有预防措施并尽量缩短手术时间。• Surgeons and personnel present in the operation theater were in the appropriate personal protective equipment (PPE).
• 手术室中的外科医生和其他人员皆配备适当的个人防护设备（PPE）。
• Disposable trocars were used, and the seals of trocars were properly checked for any leaks.
• 使用一次性套管针，并充分检查套管针的密封装置确保不存在泄漏。
• Electrosurgical and ultrasonic devices were used in a low-power setting, and prolonged desiccation was avoided to minimize plume production.
• 在低功率设置下使用电外科和超声设备，避免长时间干燥以最大程度地减少羽流产生。
• Laparoscopic suction was used to remove the surgical plume, and care was taken to prevent the spillage of pneumoperitoneum in the room. In addition, care was taken to avoid rapid desufflation or loss of pneumoperitoneum, particularly during instrument exchange and specimen removal.
• 使用腹腔镜抽吸术去除手术烟羽，并注意防止气腹在手术室内溢出。此外，注意避免气腹快速排出或丢失，尤其是在更换器械和取出标本期间。
• Surgery was conducted at a low intra-abdominal pressure (10-12 mmHg) as much as feasible.
• 手术尽可能在低腹内压 (10-12 mmHg) 下进行。
• Before extracting the uterus through the vault, the pneumoperitoneum was desufflated with closed suction to allow the minimum escape of carbon dioxide through the vault.
• 在通过穹窿取出子宫之前，先用闭合抽吸对气腹进行排气，以便通过穹窿溢出的二氧化碳量最小。
• Care was taken to minimize blood/fluid droplet spray or spread.
• 注意尽量减少血液/流体液滴的喷洒或扩散。
• Smoke evacuation systems were used to remove the surgical plume and to desufflate the abdominal cavity inside the operating room.
• 在手术室内使用排烟系统去除手术羽流，并对腹腔进行排气。