Diseases that Harm Require Therapies that Harm Less

---Sir William Osler(1849-1919)
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ISMIVS Newsletter March&April, 2022
Newsletter 2022 March & April
2022年3&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
Dr. Aranya Yantapant
Assistant Professor of Gynecologic Endoscopic Division, Obstetric Gynecologic Department
Rajavithi Hospital, Bangkok, Thailand
Aranya Yantapant 医生
泰国曼谷 Rajavithi 医院妇科内窥镜部门助理教授

Chairman of Center of excellence of Gynecologic endoscopic surgery (RJ-GMIS)
Chairman of Gynecologic Endoscopy of the Royal Thai College of Obstetricians and Gynecologists (RTCOG)
妇科内窥镜手术卓越中心(RJ-GMIS)主席
泰国皇家妇产科学院(RTCOG)妇科内窥镜协会主席

Dr. Aranya Yantapant is the Assistant Professor of Gynecologic Endoscopic Division, Obstetric Gynecologic Department, Rajavithi Hospital, Bangkok, Thailand. She got the degree of Doctor of Medicine from Chulalongkorn University in 1993 and had been trained in Obstetrics and Gynecology, Gynecologic Oncology, as well as Gynecologic Laparoscopic Surgery from 1996 to 2009 successively in King Chulalongkorn Memorial Hospital (Thailand) and Chang Gung Memorial Surgery Hospital (Taiwan).
Aranya Yantapant 医生是泰国曼谷 Rajavithi 医院妇科内窥镜部门的助理教授。她于 1993 年在泰国朱拉隆功大学获得医学博士学位,并于 1996 年至 2009 年期间先后在泰国朱拉隆功国王纪念医院和台湾林口长庚医院接受妇产科、妇科肿瘤和妇科腹腔镜手术方面的培训。
She is an eminent obstetrician and gynaecologist having over 29 years of experience in this field and is proficient in performing normal and vacuum deliveries, cesarean sections, laparoscopic hysterectomy, and ovarian cystectomy, and ligation. Her areas of expertise are family medicine, treating infertility, transvaginal ultrasounds, menopausal gynaecology, maternal-fetal medicine, gynecologic oncology, and reproductive medicine.
她是一位杰出的妇产科医生,在该领域拥有超过 29 年的经验,精通自然分娩与真空助产手术、剖腹产、腹腔镜子宫切除术、卵巢囊肿切除术,以及结扎手术。同时,她也深耕家庭医学、不孕症治疗、经阴道超声检查、更年期妇科病、母胎医学、妇科肿瘤学和生殖医学等多个医学领域。
She is the Chairman of the Center of Excellence of Gynecologic Endoscopic Surgery and has been elected the new Chairman of Gynecologic Endoscopy of the Royal Thai College of Obstetricians and Gynecologists (RTCOG) for the period of 2022-2024. In addition, she was also an active member of various societies and associations, such as the HIFU Working Group of APAGE, Medical Council of Thailand, Thai Gynecologic Cancer Society (TGCS) and Thai Endoscopic Surgery of Gynecologic Cancer Group (TESGO).
她是妇科内窥镜手术卓越中心的现任主席,并成功当选为泰国皇家妇产科学院(RTCOG)妇科内窥镜协会的新一届(2022-2024 年)主席。此外,她也是亚太妇产科内视镜暨微创治疗医学会(APAGE)HIFU 工作组、泰国医学委员会、泰国妇科癌症学会、泰国妇科癌症内窥镜手术专组(TESGO)等多个大型组织的活跃成员。
Dr. Aranya Yantapant has been invited to deliver speeches on many global forums and webinars and has also published many publications in the fields of laparoscopic surgery, minimally invasive surgery and gynecologic oncology.
Aranya Yantapant 医生多次受邀在国际性论坛和线上会议上发表演讲,并针对腹腔镜手术、微创手术和妇科肿瘤等方面发表了数篇文章。
Read her article in laparoscopic hysterectomy:
阅读 Aranya Yantapant 医生在腹腔镜子宫切除术方面的文章:
Natural Orifice Transluminal Endoscopic Surgery-assisted Vaginal Hysterectomy versus Total Laparoscopic Hysterectomy: A Single-center Retrospective Study Using Propensity Score Analysis

Case Studies 病例分享
While there are clear limitations to the methodology of case studies in the determination of treatment protocol and establishment of new trials, the observation of a single patient can add to our understanding of aetiology, pathogenesis, natural history, treatment option and complications to promote the medical development of a particular disease, and to the clinical practice of potential junior investigators.
尽管病例研究方法在确定治疗方案、组织新的临床试验方面存在明显局限性,但对单个病例的观察研究可以帮助我们了解病因、发病机制、自然病程、治疗方法及并发症,从而促进特定疾病的医学发展,并助益初级研究人员的临床实践。
The case below was shared by Sevellaraja Supermaniam, former President of APAGE, a Consultant Obstetrician and Gynecologist at Mahkota Medical Center, Melaka, Malaysia, on TSGE (Thai Society of Gynecologic Endoscopists) Live Webinar.
本期病例由 APAGE 往届主席、马来西亚马六甲州仁爱医院妇产科顾问医师塞尔瓦在泰国妇科内镜学会(TSGE)线上研讨会上分享。
Patient Info 患者信息
38yr old lady P2
Noted adenomyosis before the second pregnancy
Adenomyosis started getting bigger during pregnancy
38岁女性,二次妊娠
第二次妊娠前患子宫腺肌症
孕期中病灶变大
Given GnRH analogue and then Mirena in 2019
Increasing in size over the last 6 months from 3cm to 5cm
Pain from left groin pulling to the leg, now to the right side
Gaining a lot of weight with Mirena
2019年先用GnRH类似物,后用曼月乐加以治疗
过去六个月间子宫增大3-5厘米
疼痛自左腹股沟向腿部延伸,现右侧也开始出现疼痛
Achieving 53.4% reduction in volume of uterus.
治疗后子宫尺寸缩小53.4%。
Watch the session >
News新闻
Resounding Success of IWD-HIFU 2022:
Nearly 150 Hospitals Participated the World's Third Multicenter
近 150 家医院参与!第三届全球多中心远程协同手术保子宫公益行动圆满成功
Themed on Empowering Women Health through Technology, the World’s Third Multicenter Telemedicine Womb-preserving Campaign brought to a successful conclusion on March 7, 2022. The Campaign was co-hosted by the State Key Laboratory of Ultrasound in Medicine and Engineering of China (SKLUME), the National Engineering Research Center of Ultrasound Medicine of China (NERCUM) and the International Society of Minimally Invasive and Virtual Surgery (ISMIVS) in Liangjiang District, Chongqing, China, attracting 147 global HIFU centres to join online and together deliver HIFU treatment, an innovative noninvasive therapy, for women with uterine fibroids and/or adenomyosis. The Campaign also witnessed the world’s first trans-provincial HIFU surgery using 5G technology.
2022 年 3 月 7 日,超声医学工程国家重点实验室、超声医疗国家工程研究中心联合国际微无创医学会及全球 147 家医院的 HIFU 中心,在重庆两江新区举办了主题为“科技赋能 关爱女性”的第三届全球多中心远程协同手术保子宫公益行动(以下简称“公益活动”),远程协同帮助患子宫肌瘤、子宫腺肌症等疾病的女性实施“无创伤”的聚焦超声消融手术。世界首台跨省 5G 远程聚焦超声消融手术亮相本次公益活动。
Prof. Lang Jinghe, the academician of the Chinese Academy of Engineering and Honorary Professor of Gynecology and Obstetrics in PUMC Hospital, addressed that the minimally invasive technology represented by high intensity focused ultrasound (HIFU) has promoted the humanization and minimization of clinical surgery, unfolding a new prospect for modern medicine. For today’s surgical treatment, apart from the mission of removing the lesion, the awareness of “protecting patient’s body function” should be engraved in every doctor’s mind.
中国工程院院士、北京协和医院妇产科名誉主任郎景和致辞,以聚焦超声消融为代表的微无创技术,推动了临床外科治疗的人性化和微创化,为现代人文医学展示了新的前景。当今的外科手术除了切除必须要切的病灶以外,“功能保护”的意识应该刻在每一个医生脑海中。
Prof. David Cranston, the Associate Professor of Surgery in the Nuffield Department of Surgical Sciences at the University of Oxford and President of ISMIVS, said that women who lose their uterus are not only deprived of the opportunity to become a mother but also seriously harmed in both physical and mental ways. Compared to traditional surgical options, HIFU enjoys the same effectiveness, but with less damage to the uterus and is more conducive to post-operative pregnancy. HIFU is one of the most typical representative technologies and pioneers in the field of minimally invasive and non-invasive medicine
英国牛津大学教授、国际微无创医学会主席 David Cranston 致辞,失去子宫的女性不仅被剥夺了做母亲的机会,还严重影响女性的身心健康。与传统手术相比,聚焦超声消融手术具有相同的有效性,且对子宫的伤害更小,更有利于术后怀孕。聚焦超声消融手术是微无创领域最典型的代表,也是先行者之一。
As a saying advocated by the Chinese traditional culture goes “Don't overlook a good deed because of its insignificance while a turn to an evil deed because of its triviality”, the minimally invasive and noninvasive treatment aims to minimize the medically induced harm to patients, perform local management with the principle of maximizing the integrity of tissues and organs, fully improve patient’s own resistance to disease, rebuild patient’s body function, and help them achieve a sound mind and body, which all, in turn, give minimally invasive and noninvasive medicine a deeper meaning that goes beyond medical treatment – a meaning in promoting human civilization.
微无创医学理念就是倡导在治疗疾病的时候,努力把对病人造成的医源性伤害降到最小的程度,诚如中华传统文化思想之倡导:不以善小而不为,不以恶小而为之。以最大限度地保留组织器官的完整性为基础的局部治疗,充分调动患者自身的抗病能力,恢复并重建人体健康态的自组织功能,或者真正意义上的身心健康,这是微无创医学概念超出医学诊疗而影响人类文明的更广的意义,而聚焦超声消融技术正是微无创医学的践行者。
Based on the principle that the high temperature produced by the sunlight focused under a magnifying glass can ignite a piece of paper, HIFU treatment uses the physical properties of ultrasound such as good tissue penetration and focusability to precisely focus numerous beams of low-intensity ultrasound emitted outside the body on target tissues, which amplifies the sound intensity of the focal point tens of thousands of times and instantly generates a high temperature of 65-100°C. Using the thermal effect, cavitation effect, mechanical effect and acoustic-chemical effect of focused ultrasound, the target tissues are irreversibly coagulated and necrotic to achieve the purpose of rapid and precise non-invasive treatment.
就像太阳光可以在放大镜下聚焦,焦点的高温可以点燃纸片。聚焦超声消融技术利用超声波良好的组织穿透性和可聚焦性等物理特性,将体外发射的无数束低声强超声波精确聚焦于体内靶组织处,焦点声强得到数万倍放大,瞬间产生 65-100℃ 高温,利用聚焦超声的热效应、空化效应、机械效应及声化学效应等,使靶组织产生不可逆凝固性坏死,达到快速精准且无创治疗的目的。
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Notice通知
APAGE-ISMIVS HIFU Series Webinars 2022
2021 年国际微无创医学会(ISMIVS)与亚太妇产科内视镜暨微创治疗医学会(APAGE)联合会议
暨 2021 年高强度聚焦超声(HIFU)系列线上研讨会(AIH)
APAGE and ISMIVS developed HIFU Series Webinars in 2020 to provide a platform where colleagues and beginners in the field of non-invasive and minimally invasive medicine can meet and exchange ideas. AIH is designed and delivered by renowned international experts with the latest research, clinical practice, and live demonstrations in terms of high intensity focused ultrasound, a sound and innovative technique for gynecologic diseases.
HIFU 系列线上研讨会由 APAGE 和 ISMIVS 于 2020 年发起,旨在搭建供微无创医学领域的同僚及初学者交流学习的平台,汇集全球知名专家,分享高强度聚焦超声(治疗妇科疾病的一种创新、无创技术)方面的最新研究、临床实践,以及手术过程演示。
AIH 2022 will see a fully hybrid program, combining the best features of our past programs with new topics and sessions.
AIH 2022 将带来多主题的复合型线上研讨会,融合往届精彩与全新主题,聚焦HIFU发展。
Topics at a glance: 会议主题预告:
- Management of endometriosis, especially patients with fertility desire
- Treatment for placenta accreta and cesarean scar pregnancy
- Treatment for vulva and cervical diseases-new options
- Adenomyosis and fertility
- HIFU 治疗內异症,尤其针对有生育需求的病人
- HIFU 治疗胎盘植入和瘢痕妊娠
- 治疗外阴和宫颈疾病的创新选择
- 子宫腺肌症与生育
Episode 1
第 1 期
Date and Time: 18:00-20:00 (GMT+8) May 19, Thursday, 2022
Theme: Management of endometriosis, especially patients with fertility desire
Free Registration: https://bit.ly/AIH2022EP1
日期与时间:2022 年 5 月 19 日(周四)18:00-20:00(北京时间)
主题:HIFU 治疗內异症,尤其针对有生育需求的病人
注册链接:https://bit.ly/AIH2022EP1

More Events >

HIFU Special Issue 高强度聚焦超声特刊
MRI features and clinical outcomes of unexpected uterine sarcomas in patients who underwent high-intensity focused ultrasound ablation for presumed uterine fibroids
假定患有子宫肌瘤的患者接受 HIFU 消融治疗后未预料子宫肉瘤的 MRI 特征和临床结果
This article is to investigate the MRI features and clinical outcomes of unexpected uterine sarcomas in patients after high-intensity focused ultrasound (HIFU) ablation for presumed uterine fibroids.
本文主要研究假定患有子宫肌瘤的患者接受高强度聚焦超声(HIFU)消融治疗后未预料子宫肉瘤的MRI特征和临床结果。
Among the 15713 patients who received HIFU treatment for presumed uterine fibroids, 8 patients were found to have an occult recurrence during the follow-up period, and 6 were confirmed histologically as uterine sarcomas after laparotomy. The incidence rate of uterine sarcomas was 0.108% (17/15759). Among them, 12 cases were low-grade endometrial stromal sarcoma (LG-ESS) and 5 cases were uterine leiomyosarcoma (LMS). No histological dissemination of the sarcoma was detected in patients with unexpected uterine sarcomas.
在接受 HIFU 治疗的 15713 例假定子宫肌瘤患者中,8例患者在随访期间出现隐匿性复发,而 6 例在剖腹手术后被组织学确认为子宫肉瘤。 子宫肉瘤的发病率为 0.108%(17/15759)。 其中,有 12 例是低度子宫内膜肉瘤(LG-ess),5 例子宫平滑肌肉瘤(LMS)。 在未预料子宫肉瘤患者身上并未检测到肉瘤的组织学传播。
Although some MRI features of uterine sarcomas and uterine fibroids overlapped, MRI is valuable in distinguishing between uterine fibroids and uterine sarcomas. HIFU does not seem to cause histological dissemination of the sarcoma, but follow-up visits should be strictly adhered to in order to detect unexpected uterine sarcomas at an early stage and to treat them in a timely manner.
尽管子宫肉瘤和子宫肌瘤的某些 MRI 特征相重叠,但 MRI 在区分子宫肌瘤和子宫肉瘤方面仍然十分重要。目前看来, HIFU 似乎并没有引起肉瘤的组织学传播,但应严格执行后期随访,以便在早期发现未预料的子宫肉瘤并及时治疗。
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Tech Update in Gynaecological Endoscopy 妇科腔镜技术最新进展
Hysteroscopic myomectomy: The guidelines of the International Society for Gynecologic Endoscopy (ISGE)
宫腔镜子宫肌瘤切除术:国际妇科内镜学会 (ISGE) 指南
With this publication, the International Society for Gynecologic Endoscopy (ISGE) aims to provide the clinicians with the recommendations arising from the best evidence currently available on hysteroscopic myomectomy (HM).
国际妇科内镜学会 (ISGE) 旨在收集目前宫腔镜子宫肌瘤切除术 (HM)方面 的最佳证据,并为临床医师提供相应的指导建议。
Here are some Highlights:
亮点节选:
1. Hysteroscopic myomectomy is the most effective conservative surgical intervention for submucous leiomyomas (LM). 宫腔镜子宫肌瘤切除术是治疗黏膜下肌瘤最有效的保守手术干预方式。
2. Slicing technique or morcellation for type 0 and slicing technique for type 1 and 2 leiomyomas are recommended. 推荐0 型平滑肌瘤采用切片技术或粉碎技术,1 型和 2 型平滑肌瘤采用切片技术。
3. Prevention of complications, including continuous and accurate measurement of absorbed distension fluid, is fundamental.最基础的并发症预防措施包括连续、准确地测量吸收的膨胀液。
They concluded that HM is the most effective conservative minimally invasive gynecologic intervention for submucous LM. The set of 14 ISGE recommendations can significantly contribute to the success of HM and the safety of patients for whom the choice of appropriate surgical technique, as well as the surgeon's awareness and measures to prevent complications, are of the utmost importance.

该指南得出结论,HM 是治疗黏膜下 LM 最有效的保守妇科微创干预措施。 ISGE 的 14 条建议可以显著促进 HM 的成功,保障患者的安全。选择适当的手术技术、加强外科医生的意识,以及并发症的预防措施都极为重要。


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