Diseases that Harm Require Therapies that Harm Less

---Sir William Osler(1849-1919)
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Minimally invasive therapy of adenomyosis


“Strategies and Techniques for Minimally Invasive and Noninvasive Treatment of Adenomyosis” , one section of The Fifth Yangtze International Summit of Minimally Invasive and Noninvasive Medicine & 2023 "One Belt One Road" Innovation Forum on Minimally Invasive and Noninvasive Medicine has been successfully held on July, 9th.

This section was cochaired by Oliver Cruz, president of the Mexican Association of Gynecological Endoscopy and Microsurgery, Lin Hanmei, director of department of gynecology of the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine, Fan Xiaobin, director of department of gynecology and obstetrics of Xi'an Third Hospital, Liu Xunjiao, director of the department of women's health, Sun Xin, deputy director of department of gynecology of the Third Xiangya Hospital of Central South University, Aizura Adlan of the University of Malaysia. Centering on the theme of the section, six experts shared their brilliant lectures and had discussions on minimally invasive therapy of adenomyosis, which should be able to cure the illness, improve  life quality while at the same time minimize harm to patients.

Sevellaraja Supermaniam, consultant obstetrician and gynaecologist, director of IVF Center and HIFU Center of Mahkota Medical Centre (Malaysia), shared a lecture themed “Infertility with adenomyosis - How can HIFU help?”. HIFU therapy causes minimal harm to uterus and plays a key role in protecting fertility. It would be a good choice for patients with infertility caused by adenomyosis.
Fu Chun, director of Department of Gynecology, Xiangya Second Hospital, Central South University, gave a course on the whole course management model of focused ultrasound ablation for Adenomyosis. The course of adenomyosis is progressive, and hysterectomy is the only radical treatment at present. For patients with adenomyosis, HIFU is a new and safe therapy that helps to avoid uterine surgery or hysterectomy, and personalized comprehensive management is required after receiving the treatment.
Pu Yuanfang, chief physician of People's Hospital of Nanchuan District, Chongqing discussed on clinical study on focused ultrasound ablation combined with thermal balloon endometrial ablation in the treatment of endogenous adenomyosis. The combined therapy is considered to be clinical effective and overall safety. Continuous exploration should be made to find out new clinical options that can save uterus, alleviate symptoms, improve life quality and reduce recurrence for patients with endogenous adenomyosis.
Peng Yan, director, chief physician of HIFU center of Shenzhen Maternal and Child Health Hospital shared a lecture on treatment strategies after the failure of conservative treatment for adenomyosis. Comprehensive therapy centered around HIFU can maximize efficacy and minimize harm through minimally invasive treatment. Comprehensive HIFU therapy could be adopted after the failure of conservative treatment for adenomyosis to control clinical symptoms effectively. For recurrence after comprehensive HIFU therapy, repeatable treatment could be applied to control clinical symptoms and reduce hysterectomy rates.
Liang Dong, deputy director/chief physician of the department of internal gynecology, Foshan First People's Hospital, lectured on “Comprehensive treatment for patients with adenomyosis with fertility needs”. Endometriosis is a complex syndrome characterized by estrogen-dependent chronic inflammatory process. Comprehensive treatment for patients with adenomyosis must be precise and personalized. Reasonable selection of focused ultrasound ablation pretreatment for adenomyosis patients with fertility needs can bring more benefits.
Guo Tao, chief physician of West China Second Hospital of Sichuan University, shared his opinions on “HIFU in the treatment of endometriosis and adenomyosis”. HIFU therapy has many advantages in the treatment of adenomyosis and endometriosis, but there are also some shortcomings including long existence and slow absorption of lesion after the treatment, treatment dosage and intensity depending on physician’s experience, intimal and serosa damage caused by excessive energy, posing certain requirements for doctors.

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