Disruptive Solution of Medical Endoscopy in Gynecology and Reproductive Medicine Diagnosis and Treatment

1、 Revolutionary breakthrough in hysteroscopy technology

(1)Cold knife hysteroscopy system

Technological disruption:

Mechanical planing (such as MyoSure) ®）： The rotating blade with a speed of 2500rpm precisely removes fibroids to avoid electric heating damage to the iner membrane substrate.

Fluid pressure control system: Maintain uterine pressure between 50-70mmHg (traditional electrocautery>100mmHg) to reduce the risk of fluid overload.

Clinical value:

The repair time of the endometrium after submucosal fibroid resection has been shortened from 12 weeks to 4 weeks after electrocautery.

The natural pregnancy rate of infertile patients after surgery increased to 58% (compared to only 32% in the electrocautery group).

(2)3D hysteroscopy navigation

Technical highlights:

Real time 3D modeling (such as Karl Storz IMAGE 1 S Rubina): displaying the depth of the uterine horn and the shape of the fallopian tube opening.

Combined with preoperative MRI data, the accuracy of identifying uterine malformations (such as complete mediastinum) is 100%.

Application scenarios:

Stereoscopic quantitative grading of intrauterine adhesions (Asherman syndrome).

(3)Fluorescence staining hysteroscope

Technological breakthrough:

5-ALA induces tumor protoporphyrin IX fluorescence, with a detection sensitivity of 91% for early endometrial cancer (only 65% under white light microscopy).

According to data from the National Cancer Center of Japan, atypical endometrial hyperplasia lesions of less than 1MM can be detected.

2、 Paradigm reconstruction of laparoscopic technology

(1) Single port robotic laparoscope (SPRS)

Da Vinci SP System:

A 25mm single incision is used to complete total hysterectomy, which increases the cosmetic degree by 80% compared to porous surgery.

The patented wrist instrument achieves 7-degree-of-freedom operation, with a sewing and knotting accuracy of 0.1mm.

Clinical data:

The retention rate of normal ovarian tissue during ovarian cystectomy is greater than 95% (traditional laparoscopy is about 70%).

(2) Near infrared fluorescence navigation (NIR)

ICG lymphatic mapping:

Real time display of sentinel lymph nodes during cervical cancer surgery reduces unnecessary lymph node dissection by 43%.

Fudan University Affiliated Cancer Hospital Plan: Combining indocyanine green and nanocarbon dual labeling, the detection rate has been increased to 98%.

(3)Upgrade of Ultrasonic Energy Platform

Harmonic ACE+7：

Intelligent adjustment of vibration frequency (55.5kHz ± 5%), cutting and closing 5mm blood vessels simultaneously.

The amount of bleeding during uterine fibroid removal surgery is less than 50ml (traditional electrocautery>200ml).

3、 Minimally invasive solutions for reproductive medicine

(1) Hysteroscopy intervention for recanalization of fallopian tubes

Technical combination:

0.5mm ultra-fine fiber mirror (such as Olympus HYF-1T) combined with guide wire hydraulic expansion.

Real time pressure monitoring system (<300mmHg) to prevent fallopian tube rupture.

Therapeutic effect:

The recanalization rate of proximal obstruction is 92%, and the natural pregnancy rate at 6 months after surgery is 37%.

(2) Ovarian tissue freezing+endoscopic transplantation

Disruptive process:

Step 1: Obtain ovarian cortex through transvaginal laparoscopy (avoid laparotomy).

Step 2: Vitrification and freezing preservation.

Step 3: Autologous transplantation into the ovarian fossa after chemotherapy to restore endocrine function.

data

Brussels program in Belgium: Ovulation rate of 68% after transplantation in post adolescent patients.

(3) Endometrial receptivity test (ERT)

Molecular endoscopic technology:

Collect endometrial tissue under hysteroscopy and determine the implantation window through RNA sequencing.

Improve the clinical pregnancy rate of patients with repeated implantation failures from 21% to 52%.

4、 Minimally invasive innovation in pelvic floor repair

(1) Transvaginal Mesh Implantation (TVM)

Technological evolution:

3D printing personalized polypropylene mesh with porosity>70% reduces the risk of infection.

Robot assisted precise placement to avoid damage to the obturator nerve.

Therapeutic effect:

The 5-year recurrence rate of pelvic organ prolapse (POP) is less than 10% (traditional suture surgery 40%).

(2) Sacral nerve regulation endoscopic implantation

InterStim ™ Minimally invasive plan:

Sacral 3-hole puncture under cystoscopy, with an effective rate of over 80% during the testing period before permanent implantation.

The improvement rate of urinary control in the treatment of refractory urinary incontinence is 91%.

5、 Future technological directions

(1)Real time diagnosis of AI uterine cavity lesions:The EndoFinder system from Samsung has an accuracy rate of 96% in identifying endometrial polyps and cancer.

(2) Absorbable electronic bracket:The magnesium based scaffold developed by Northwestern University in the United States degrades and releases growth promoting factors within 6 months.

(3) Organ chip simulation transplantation:Rehearsing uterine transplantation vascular anastomosis strategy on microfluidic chip.

Clinical Benefit Comparison Table

Pain points of traditional technology methods/effectiveness of disruptive solutions

Cold knife hysteroscopy/electrosurgical injury of endometrial stem cells/postoperative adhesion rate reduced from 28% to 5%

Single hole robotic laparoscopic/multi hole surgery with obvious scars/restoration of daily life 24 hours after surgery

High false positive rate of fluorescence falloposcopy/hysterosalpingography/accurate localization of true obstruction up to 0.1mm

Ovarian tissue freezing transplantation/post chemotherapy ovarian premature failure/menstrual cycle recovery rate>60%

Implementation path suggestions

Primary hospitals: equipped with high-definition hysteroscopy and cold knife system, covering 90% of intrauterine lesions.

Reproductive Center: Establish an integrated platform for fallopian tube endoscopy and embryo transfer.

Oncology Specialty: Promote precise tumor resection using NIR fluorescence navigation.

These technologies are redefining the standards of minimally invasive gynecological surgery through three core breakthroughs: millimeter level precision, zero fertility damage, and physiological function reconstruction. It is expected that by 2027, 90% of gynecological benign disease surgeries will achieve "daytime" treatment.