I am used to seeing all kinds of patients and conditions in my daily outpatient surgeries, so I can be calm and unperturbed when I encounter any “special” cases. But since I met a patient with adenomyosis who came all the way from Changchun, northeast China, I was still shocked by her. Because she had 23 visits to …… for adenomyosis treatment, I was shocked by her perseverance in conservative treatment of adenomyosis and surprised by her dedication to one treatment modality. Is the treatment of adenomyosis effective? How does it work? What is Helio knife? It is a new technology to eliminate tumors in human body. This surgery is non-invasive and non-bleeding, which is also called “non-invasive surgery”. It works like focusing sunlight with a convex lens to produce a high temperature focus. It is a precise positioning to destroy tumor cells from outside the body. The low-energy ultrasound from outside the body is focused during the process of tissue penetration, and the instantaneous high temperature (65~100) and cavitation effect generated by the high-energy ultrasound in the focal area cause the tumor to coagulate and necrosis, and the cavitation effect causes the cell membrane to rupture and lose the ability to spread. In the treatment, the focus of ultrasound entering the body is as big as a soybean, and the tumor is burned to death layer by layer through the trajectory of dotted line and surface. The coagulated necrotic tissues are gradually absorbed by the human body. The origin of Helio knife for adenomyosis The use of Helio knife for adenomyosis, like the use of Manuelle for adenomyosis, is a bit of a “transfer” because neither Helio knife nor Manuelle was originally designed to treat adenomyosis, the former was for tumors and the latter was for contraception. The former is for tumors and the latter is for contraception. So to use them to treat adenomyosis is a bit “difficult for them”. The use of the Helio knife for adenomyosis is also a result of a later “secondary creation”: since it can destroy tumors, it must also be effective in controlling the foci of adenomyosis. It has been proven that the Hibiscus can have an immediate effect on the treatment of some focal tissues of adenomyosis, as it can effectively coagulate and carbonize some of the tissues, causing them to atrophy and stop spreading. But its limitations are also very big. The limitations of the Helio knife for adenomyosis The working principle of the Helio knife tells us that it mainly coagulates and carbonizes the central part of the tumor to make it necrotic and stop growing. For adenomyosis, which is a disease with a diffuse distribution of lesions and no visible borders, it is a bit “weak”. Because the foci of adenomyosis are widely scattered and uneven, and the knife can only work on a small part of the focal tissue, it is not able to start effective treatment for a large area of focal areas. If the focus area of the knife is too large, it will inevitably injure the surrounding connected tissues, such as the bladder and intestines. Even the more accurate magnetic wave knife (MRI+Hyperkinesis) technology does not dare to perform high-temperature focusing in the adjacent areas of the lesion and surrounding organs. As I mentioned in my previous article, the treatment lesion treatment of adenomyosis with HEF, magnetic wave knife, and ultrasonic ablation is like an apple that has been nibbled and a scoop of ice cream that has been scooped away. The large adenomyosis and adenomyoma lesion tissues are only dealt with the tip of the iceberg, and most of the lesion tissues are still there, so the treatment is not effective or easy to recur. The right side of the picture above is the focal tissues of adenomyosis, and the left side is the focal tissues of adenomyosis that were excavated by the uterus preservation U surgery. The symptoms of adenomyosis start to be painful again after one or two years. As a gynecologist, objectively speaking, the Helio knife is not a good medical technology, it has excellent results in the treatment of liver tumors, soft tissue tumors, uterine fibroids and other fields. But using it to treat adenomyosis, in my opinion, requires careful consideration depending on the patient’s condition, because it has very significant limitations. There may be some patients with adenomyosis who have undergone the procedure and have improved significantly or have been completely cured, which we cannot deny, but medicine should be universally applicable. If you try it, it is not recommended to try it one or two dozen times, just like the Northeast China patient I mentioned, who did not work once. Learning to “stop when you can” is sometimes a way to take responsibility for yourself in order to seek better medical techniques for uterine preservation for adenomyosis. Ovarian cancer is the most common malignant tumor among female gynecological malignant tumors, and its mortality rate is the highest among gynecological malignant tumors, and most of them are already in advanced stages when discovered. After ovarian cancer is treated with a combination of tumor cell reduction surgery and chemotherapy, it can be reviewed regularly, but a large proportion of patients still have recurrence. Recurrence of ovarian malignant tumor refers to clinical remission after satisfactory tumor cytoreductive surgery and regular and adequate chemotherapy, and then recurrence of tumor after six months of drug withdrawal. Ovarian cancer recurrence is mostly multiple recurrence, and metastases mostly occur in the pelvis, abdomen and vaginal stump. Lymph node metastasis is common, and some of them may metastasize to liver, lung, brain and other organs, and CT and MRI can clarify metastasis. The self-conscious symptoms of ovarian cancer recurrence are similar to those of ovarian cancer: 1. Abdominal distension and ascites. As tumor cells gradually increase in size, they will also metastasize to the abdominal cavity and peritoneum, stimulating capillaries and increasing capillary permeability, so that a large amount of protein and fluid will leak out, causing ascites, which will cause patients to feel bloated and unbearable; 2, loss of appetite and emaciation, etc. Because tumor cells compress and pull the surrounding tissues and ligaments, coupled with the stimulation of ascites, they often show gastrointestinal symptoms such as loss of appetite. In serious cases, cachexia may also occur; 3. Abnormal bowel movement. Because the tumor invades the digestive system or the tumor is too large to block the intestinal tract, it may cause difficult defecation or bloody stool; 4.or the recurrent mass is large, some patients can find the abdominal mass by themselves. Post-operative recurrence and metastasis of ovarian cancer often have great impact and burden on patients’ psychology, which seriously affects patients’ survival quality. Patients should pay attention to improve body immunity, exercise appropriately and adjust their mentality after surgery to avoid recurrence.