A 7.5-MHz finger-grip ultrasound probe for real-time intraoperative guidance during complex reproductive surgical
Gerard S Letterie1, William H Catherino
1Center for Fertility and Reproductive Endocrinology, Virginia Mason Medical Center, Seattle, WA 98110, USA.
Objective:
A 7.5-MHz finger-grip probe was used to monitor intra-abdominal reproductive surgery in two groups of patients.
Study Design:
The first group of patients underwent transabdominal myomectomy for multiple uterine leiomyomas (n = 3) and the second group underwent uterine reconstruction and excision of obstructive uterine horn (n = 3). Intraoperative real-time imaging was accomplished by direct application of the finger-grip probe to the uterine serosa by using saline solution as a transmission media. Ultrasound imaging and surgical dissection were carried out both sequentially and simultaneously.
Results:
In the first group of patients, the finger-grip probe provided precise location of the leiomyomas and intraoperative guidance for dissection during the myomectomy. In the second group of patients, the finger probe provided images of intrauterine anatomy in one patient who had a normal-sized and normal-shaped uterus with an obstructed intracavitary horn and hematometrium. In two other patients, the obstructed uterine horn extended deep into the pelvis lateral to the vagina. Real-time imaging provided intraoperative monitoring of depth of dissection into the paravaginal space.
Conclusion:
The finger-grip probe demonstrated intrauterine anatomy and enabled a more directed surgical approach, both in placement of uterine incisions for surgical reconstruction and excision of obstructed horns for mullerian abnormalities and in identification and dissection for leiomyomas.
