1.About the technique Surgical procedure: choose a 3mm puncture point (equivalent to the size of rice grain, no suture is needed after surgery) at the root of one thigh, insert a special catheter into the uterine artery, which is the blood supply of myoma, and apply biological material to embolize the uterine artery to make the myoma or lesion ischemic, anoxic and necrotic, and pull out the catheter after surgery. If a vascular suture is applied to close the vessel, the patient can move freely after 30 minutes; if compression is taken to stop the bleeding, it takes 6 hours to move freely. The necrotic fibroids are absorbed or discharged by the body, and the fibroids shrink significantly and disappear in some patients 3-6 months after surgery. Applicable diseases: Uterine fibroids, adenomyosis, postpartum bleeding, ectopic pregnancy, pre- and post-operative treatment of gynecological malignancies. Operating time: 30-60 minutes, usually around 40 minutes, and more than 60 minutes in very rare difficult cases. Bleeding volume.
10~30ml. Postoperative recovery time: You can eat on the day after surgery and be discharged from the hospital in 4-5 days. Differences from traditional techniques: (1) no incision; (2) little damage: little damage to normal organs; (3) fast recovery: does not affect eating. 2, adenomyosis Uterine adenomyosis is currently the most difficult to treat gynecological diseases, commonly known as “chronic cancer”. Unbearable progressive dysmenorrhea and excessive menstrual flow are the two most tormenting symptoms, and a significant number of patients suffer from infertility. There is no ideal treatment: drugs are only effective for a short period of time and have a lot of side effects, and cannot be used for a long time. The most definitive solution is to remove the uterus, but since the number of young patients with adenomyosis is increasing, removal of the uterus is clearly not an ideal solution. The advent of interventional therapy has brought light to the treatment of this disease. Our follow-up study of more than 300 cases of adenomyosis with interventional therapy found that 80% of patients with adenomyosis could have their dysmenorrhea relieved or completely disappeared after interventional therapy, and 98% of patients with excessive menstrual flow disappeared; 28.3% of patients with fertility requirements could have pregnancy after interventional therapy. Therefore, interventional treatment of adenomyosis is a milestone in the conservative treatment of adenomyosis. 3.Uterine fibroids The study of thousands of cases of interventional treatment of uterine fibroids and the comprehensive domestic and foreign literature: the efficiency of interventional treatment of uterine fibroids is 98.2%, the failure rate is 1.8%, the five-year recurrence rate of fibroids is 3%, and the pregnancy rate of patients with fertility requirements is 27.9% 2 years after the operation. Therefore, interventional therapy is a good choice for patients with fibroids. The degree of fibroid shrinkage after intervention differs between different types of fibroids, and in general, the more vascular the fibroid is, the better the result. Therefore, patients requesting interventional treatment need to go to the hospital for a comprehensive evaluation by a specialist. About 5% of patients are not suitable for interventional treatment (e.g. fibroids with few blood vessels, fibroids with necrosis, calcification, cystic changes, malignant changes, etc.). After interventional treatment of uterine fibroids, only the vessels of the fibroids are embolized and the vessels of the uterus and ovaries are not damaged, so the function of the uterus is still intact and there will be normal menstrual flow and pregnancy, so contraception is needed for those who do not have fertility requirements after surgery. However, permanent amenorrhea may occur in one in a thousand patients for various reasons, among which allergy to embolic or contrast agents or drugs is a possible cause. 4, postpartum hemorrhage Postpartum hemorrhage is the first cause of maternal death, the vast majority of postpartum hemorrhage can be cured by conservative treatment, but a small number of refractory postpartum hemorrhage conventional conservative treatment is ineffective to remove the uterus as the ultimate cost. The application of interventional therapy has changed this situation and become a milestone in the treatment of postpartum hemorrhage, and the technique has good clinical efficacy for various postpartum hemorrhages, with an efficiency of over 98%. However, it is important to pay attention to the specific application in the clinic and choose interventional treatment as early as possible when the conventional conservative treatment for postpartum hemorrhage is ineffective, so as not to miss a good opportunity. 5, ectopic pregnancy Interventional treatment also has good clinical effect on ectopic pregnancy, but we choose according to different situations when it is applied in clinical practice. For cervical pregnancy and horn pregnancy (not really ectopic pregnancy) once diagnosed first interventional treatment; for tubal pregnancy laparoscopic treatment is preferred instead of interventional treatment (although it has better clinical results), but in cases of multiple tubal pregnancies interventional treatment is a good method. 6., gynecologic malignant tumors Interventional therapy was first applied to palliative treatment of gynecologic malignant tumors and hemostasis of gynecologic malignant tumor bleeding. In clinical application, it was found that interventional treatment can make cancer tumors shrink significantly or even disappear, achieve the effect of down-staging and down-grading, and make inoperable mid- to late-stage gynecologic malignant tumors obtain the opportunity of surgery, thus gaining space for later treatment. At present, interventional therapy is mainly applied to preoperative neoadjuvant chemotherapy for gynecologic malignancies with high-risk factors, such as preoperative chemotherapy for cervical cancer above stage II and cancer tumors with poor cell differentiation; it can also be applied to postoperative treatment of gynecologic malignancies. (1) Cervical cancer: Studies have shown that the five-year survival rate of patients with mid- to late-stage cervical cancer who underwent surgery or radiotherapy after preoperative intervention has increased from 50% to 65%-70% compared with radiation therapy alone, and the quality of life of patients has improved significantly. (2) Endometrial cancer: It is still controversial in academic circles whether interventional treatment should be performed before surgery for endometrial cancer, but for patients with advanced or poorly differentiated endometrial cancer or poor tissue type, preoperative interventional treatment is still worth advocating. (3) Vaginal and vulvar cancers: preoperative interventions can help complete resection of the cancer lesion. (4) Trophoblastic lobe cell tumor: due to the high value-added of trophoblastic lobe cell tumor and its high sensitivity to ischemia and hypoxia, interventional arterial chemotherapy can effectively shorten the course of chemotherapy compared with intravenous chemotherapy. Moreover, arterial chemotherapy is equally effective in cases where intravenous chemotherapy fails.