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High-intensity focused ultrasound (HIFU) surgery is a noninvasive thermal ablation treatment modality, and its clinical application is increasingly introduced into gynecological practices in China and Asia. To further strengthen the technology's standardized management, the Asia-Pacific Association for Gynecologic Endoscopy and Minimally Invasive Therapy (APAGE) collected the consensus of well-known experts in the field. They shared opinions on the management standards of the basic requirements for developing this HIFU technology in medical institutions, operators' training requirements, technical management, HIFU training program, etc., Based on the recommendations from APAGE, Hong Kong Focused Ultrasound Surgery Association developed its proposed HIFU training program for gynecologists in Hong Kong. This paper will present the training requirements and hopefully share its training and credentialing rationales with other HIFU medical institutes.
RESUMO
This paper reflects a Hong Kong doctors group's journey to learn the high-intensity focused ultrasound (HIFU) ablation treatment for gynecological diseases in China. The procedures of HIFU ablation for fibroids, adenomyosis, and other gynecological diseases are described. After completing our training, the authors applied the HIFU ablation techniques they have learned to establish an outpatient HIFU clinic and provided HIFU ablation treatment in Hong Kong. This paper describes their early experience in providing HIFU services.
RESUMO
Conventionally, surgical management of retained placental tissue is largely performed using blind dilatation and curettage. Hysteroscopic removal using diathermy loop has been shown to be successful while increasing complete removal rates and reducing risk of uterine perforation. Our two cases demonstrated that complete removal of placental tissues can be achieved with hysteroscopic morcellation device which is known to be associated with less operative time and less operative risk compared to diathermy loop. Preoperative transamin can reduce intraoperative bleeding, while careful preparation must be made for bleeding immediately after the procedure when the hysteroscope is withdrawn and distended uterus slowly contracts.
RESUMO
OBJECTIVE: Bipolar impedance controlled radiofrequency endometrial ablation is a valuable treatment options for menorrhagia. We examined the short term outcomes of Hong Kong Chinese women undergone this procedure. MATERIAL: All patients who underwent this procedure at Queen Elizabeth Hospital, Hong Kong during January 2013 to August 2016. Method this is a prospective cohort study where the menstruation status among the selected patients was questioned at each 6 monthly follow-up after the procedure. A validated MIQ (menorrhagia impact questionnaire) was sent to assess quality of life before and after the procedure. RESULT: 44 patients underwent the procedure. 77.4% had reduced or minimal bleeding with 19.4% achieving amenorrhoea. 96.77% were found to have reduced bleeding or amenorrhoeic at 3 months; 96.3% at 6 months, 95.83% at 12 months; 95.45% at 18 months; 100% at 24 and 36 months of follow up. Endometritis occurred in 9.7%. No case required blood transfusion or other surgical management post-operatively. Improvement in all aspects of MIQ was seen when compared post-operative scores to preoperative scores (p < 0.01). 100% claimed improvement in menstruation and 87.1% suggested they would recommend the procedure to family and friends. CONCLUSIONS: Bipolar impedance controlled radiofrequency endometrial ablation appears to be an effective method for managing menorrhagia amongst Chinese women in Hong Kong.