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Use of biomedical photonics in gynecological surgery: a uterine transplantation model.

ABSTRACT: Uterine transplantation (UTx) has been proposed as a treatment for permanent absolute uterine factor infertility. The study aims were to compare pulse oximetry and multispectral imaging (MSI), for intraoperative tracking of uterine oxygen saturation in animal UTx models (rabbit and sheep).Imaging results confirmed the re-establishment of adequate perfusion in the transplanted organ after surgery. Comparison of oxygen saturation values between the pre-UTx donor and post-UTx recipient, and pre-UTx and post-UTx recipient reveals a statistically significant decrease in saturation levels post-UTx.The use of MSI is the first case in gynecology and has demonstrated promise of possible future human use. MSI technique has advantages over pulse oximetry - it provides spatial information in a real-time, noncontact manner.

SUBMITTER: Saso S

PROVIDER: S-EPMC5905613 | biostudies-other | 2018 Apr

REPOSITORIES: biostudies-other

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Use of biomedical photonics in gynecological surgery: a uterine transplantation model.

Saso Srdjan S Clancy Neil T NT Jones Benjamin P BP Bracewell-Milnes Timothy T Al-Memar Maya M Cannon Eleanor M EM Ahluwalia Simran S Yazbek Joseph J Thum Meen-Yau MY Bourne Tom T Elson Daniel S DS Smith James Richard JR Ghaem-Maghami Sadaf S

Future science OA 20180206 4

<h4>Aim</h4>Uterine transplantation (UTx) has been proposed as a treatment for permanent absolute uterine factor infertility. The study aims were to compare pulse oximetry and multispectral imaging (MSI), for intraoperative tracking of uterine oxygen saturation in animal UTx models (rabbit and sheep).<h4>Results/methodology</h4>Imaging results confirmed the re-establishment of adequate perfusion in the transplanted organ after surgery. Comparison of oxygen saturation<i> </i>values between the pr ...[more]

PMID: 29682321

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Project description:A cluster of hepatitis C virus (HCV) infections among gynecological patients who underwent surgical intervention in the same setting is described. An epidemiological investigation was conducted to identify the cases, the likely source of infection, and the route of transmission. Four recent HCV infections were identified. Based on molecular fingerprinting analysis and epidemiological investigation, transmission between the putative source patient (an HCV-positive woman who was the first patient of the surgical session) and outbreak patients was highly suggestive. All patients, including the source patient, were infected with HCV type 1b. Molecular characterization of HCV clones by sequence analysis of both structural envelope regions (20 clones from the source patient and 58 from the outbreak patients) and the nonstructural NS5 region of the viral genome (12 clones from the source patient and 32 from the outbreak patients) showed close homology between the viral isolates from the source and those from the outbreak patients that was higher than that observed between the viral isolates from the source and those from four unrelated, HCV type 1b-infected patients from the same geographical area (in the latter case, 33 clones were sequenced for the envelope regions and 30 were sequenced for the NS5 region). The mean percent divergence between clones was 4.69 for the envelope and 3.71 for the NS5 region in the source patient and the outbreak patients compared with 6.76 (P = 0.001) and 5.22 (P = 0.01) in the source patient and control patients, respectively. Among the risk factors investigated, only that of having undergone surgery in the morning session of the same day reached statistical significance (P = 0.003). The investigation showed that the source patient and outbreak patients shared only the administration of propofol in multidose vials. The study documents the risk of nosocomial transmission of HCV and the importance of infection control procedures in the operating room and highlights the crucial role of molecular strategies, especially sequence-based phylogenetic analysis of cloned viral isolates, in the investigation of HCV outbreaks.

Project description:AbstractNew generation supraglottic airway devices are suitable for airway management in many laparoscopic surgeries. In this study, we evaluated and compared the ventilation parameters of the laryngeal mask airway-supreme (LM-S) and endotracheal tube (ETT) when a neuromuscular blocker (NMB) agent was not used during laparoscopic gynecological surgery. The second outcome was based on the evaluation of the surgical view because it may affect the surgical procedure.This was a randomized study that enrolled 100 patients between 18 and 65?years old with an ASA I-II classification. Patients were divided into 2 groups: Group ETT and Group LM-S. Standard anesthesia and ventilation protocols were administered to patients in each group. Ventilation parameters [airway peak pressure (Ppeak), mean airway pressure (Pmean), total volume, and oropharyngeal leak pressure] were recorded before, after, and during peritoneal insufflation and before desufflation, as well as after the removal of the airway device. Perioperative surgical view quality and the adequacy of the pneumoperitoneum were also recorded.The data of 100 patients were included in the statistical analysis. The Ppeak values in Group ETT were significantly higher in the second minute after airway device insertion. The Ppeak and Pmean values in Group ETT were significantly higher before desufflation and after removal of the airway device. No significant differences were found between the groups in terms of adequacy of the pneumoperitoneum or quality of the surgical view.The results of this study showed that gynecological laparoscopies can be performed without using a NMB. Satisfactory conditions for ventilation and surgery can be achieved while sparing the use of muscle relaxants in both groups despite the Trendelenburg position and the pneumoperitoneum of the patients, which are typical for laparoscopic gynecological surgery. The results are of clinical significance because they show that the use of a muscle relaxant is unnecessary when supraglottic airways are used for these surgical procedures.

Dataset Information

Use of biomedical photonics in gynecological surgery: a uterine transplantation model.

Publications

Use of biomedical photonics in gynecological surgery: a uterine transplantation model.

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