In-vitro and in-vivo histochemical and thermal studies using a thermal balloon endometrial ablation system for varying treatment times

Authors: Jeremy Hawe¹; Jason Abbott²; Graham Phillips²; Nafisa Wilkinson³; Sean Duffy³; Ray Garry⁴

Source: Human Reproduction, Volume 18, Number 12, December 2003 , pp. 2603-2607(5)

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Abstract:

BACKGROUND: To assess the immediate zone of thermal necrosis (ZTN) using an enzyme histochemical staining technique and serosal temperatures for the Cavaterm endometrial balloon ablation system for different treatment times. METHODS: A thermal balloon ablation was performed initially post- (n = 6) and subsequently pre-hysterectomy (n = 15). Eight to 12 tissue blocks from each uterus were sectioned and stained using diaphorase respiratory enzyme techniques. Patients in the in-vivo group had temperature measurements taken from four serosal points, a myometrial gradient profile, the balloon surface and the endocervical canal. RESULTS: The serosal temperature sensors did not demonstrate any rise in temperature above 44.1°C. The mean temperature at the anterior wall, posterior wall, fundus and cornual areas was 37.1 (SD 1.3), 36.8 (SD 1.0), 37.4 (SD 1.8) and 36.7°C (SD 1.0), respectively. The immediate mean maximum ZTN was greatest for the 15-min treatment time (3.1 mm, SD 1.5) compared to the 10- and 7-min treatment times (3.0 mm, SD 1.4 and 2.2 mm, SD 0.7, respectively). The maximum ZTN recorded was 5.6 mm. No full thickness injuries were demonstrated either histochemically or suggested by the temperature studies. CONCLUSIONS: This study confirms that Cavaterm thermal balloon ablation produces a reproducible thermal injury without evidence of serosal heating. Results suggest that the treatment time could be reduced to 10-min with no detrimental effect on the clinical outcomes. This hypothesis is currently being evaluated by clinical trials.

Keywords: : diaphorase/endometrial ablation/serosal temperat

Document Type: Research article

DOI: http://dx.doi.org/10.1093/humrep/deg503

Affiliations: 1: Countess of Chester Hospital, Liverpool Road, Chester, UK, 2: University of New South Wales, Department of Endo-Gynaecology, Royal Hospital for Women, Randwick, New South Wales, Australia, 3: St James’ University Hospital, Beckett Street, Leeds, UK, and 4: University of Western Australia, School of Women’s and Infant’s Health, King Edward Memorial Hospital, Perth, WA 6008, Australia

Publication date: 2003-12-01

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Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.

In-vitro and in-vivo histochemical and thermal studies using a thermal balloon endometrial ablation system for varying treatment times

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