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Cryocoagulation of the endometrium at the uterine cornua.

Abstract：

:A cryoprobe that will produce coagulation necrosis and subsequent scar formation of the cornual areas of the uterus has been tested. A discussion is made of the developmental program, including the design of the instrument, efficacy and safety testing in baboons, and preliminary investigations of the safety of this procedure in man. :This paper describes a development program aimed at producing necrosis of the endometrium and subsequent scar formation of the cornual area of the uterus through use of a cryoprobe. It was hypothesized that multiple freeze-thaw cycles, followed by active warming of the tissue and abrasion of the necrotic debris, would result in uterine synechiae. It was further postulated that the development of dense scar tissue might be facilitated by the placement of tissue adhesives or a collagen plug, which would function as a matrix for the fibroblasts to form scar tissue between the adjacent walls of the myometrium. In vivo testing of the cryoprobe was accomplished in 2 phases. In the 1st phase, baboons were used to establish the extent of the necrotic isotherm and study the effects of gelatin-resorcinol-formaldehyde and collagen on scar formation. In the 2nd phase, 6 women underwent cryosurgery immediately before hysterectomy. 3 freeze cycles of 60 sec each with a 1st and 2nd warming cycle of 60 sec and a final warming cycle of 120 sec comprised the protocol. In all 6 cases, the cryoprobe produced a cylindrical area of complete coagulation necrosis of the endometrium and 3-5 mm of adjacent myometrium at the uterine cornua. There was no febrile response or leukocytosis in the series. The most significant product of this research is considered to be the engineering innovations that give surgeons a predictable area of tissue necrosis. The procedure will not be offered for sterilization, however, until longterm studies have demonstrated a lack of endometrial regeneration and evidence of cornual obstruction without recanalization.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

Droegemueller W,Greer BE,Davis JR,Makowski EL,Chvapil M,Pollard A

doi

10.1016/0002-9378(78)90466-0

subject

Has Abstract

pub_date

1978-05-01 00:00:00

pages

1-9

issue

eissn

0002-9378

issn

1097-6868

pii

0002-9378(78)90466-0

journal_volume

131

pub_type

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Cryocoagulation of the endometrium at the uterine cornua.