Feasibility of laparoscopic high-intensity focused ultrasound treatment for patients with uterine localized adenomyosis

ObjectiveTo investigate the feasibility of laparoscopic high-intensity focused ultrasound (HIFU) ablation in the treatment of patients with uterine localized adenomyosis.DesignA prospective clinical trial.SettingUniversity teaching hospital.Patient(s)Seven patients with uterine localized adenomyosis.Intervention(s)Using a hand-held focused ultrasound transducer, the HIFU procedure was performed by the same gynecologist for the treatment of a targeted adenomyosis during the surgical procedure, followed by hysterectomy.Main Outcome Measure(s)Feasibility and effectiveness of HIFU treatment of localized adenomyomas.Result(s)Macroscopic and microscopic examinations showed that HIFU induced thermal ablation of a targeted adenomyosis in all patients. The treated adenomyosis presented typical characteristics of coagulation necrosis, and the margin between the treated and untreated regions was clear in 2,3,5-triphenyltetrazolium chloride staining. By using electronic microscopy and nicotinamide adenine dinucleotide-diaphorase stain, complete loss of cellular viability was identified in the treated tissue.Conclusion(s)The HIFU treatment is feasible and effective in the treatment of patients with uterine localized adenomyosis. It may provide a promising laparoscopic treatment for localized adenomyosis.