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Table of Contents
LETTER TO THE EDITOR
Year : 2021  |  Volume : 10  |  Issue : 4  |  Page : 272-273

Noninvasive high-intensity focused ultrasound surgeries for fibroids and adenomyosis during COVID-19 Pandemic in Hong Kong: A gynecologist's viewpoint


1 Department of Obstetrics and Gynaecology, School of Women's and Children's Health, The University of New South Wales, Sydney, Australia
2 Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong, China

Date of Submission02-Feb-2021
Date of Decision15-Mar-2021
Date of Acceptance16-Mar-2021
Date of Web Publication5-Nov-2021

Correspondence Address:
Prof. Felix Wu Shun Wong
Suite 831, Central Building, 1-3 Pedder Street, Central, Hong Kong
Australia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/GMIT.GMIT_18_21

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How to cite this article:
Shun Wong FW, Li TK. Noninvasive high-intensity focused ultrasound surgeries for fibroids and adenomyosis during COVID-19 Pandemic in Hong Kong: A gynecologist's viewpoint. Gynecol Minim Invasive Ther 2021;10:272-3

How to cite this URL:
Shun Wong FW, Li TK. Noninvasive high-intensity focused ultrasound surgeries for fibroids and adenomyosis during COVID-19 Pandemic in Hong Kong: A gynecologist's viewpoint. Gynecol Minim Invasive Ther [serial online] 2021 [cited 2021 Dec 3];10:272-3. Available from: https://www.e-gmit.com/text.asp?2021/10/4/272/329868



Dear Editor,

I would like to echo the preferred gynecological surgical approach during the COVID-19 pandemic recently reported by Khoiwal and Chaturvedi in this Journal.[1] Even though there is no evidence of SARS-CoV-2 virus present in surgical smoke, transmission through pneumoperitoneum, intubation aerosols, face masks, and blood transmission is still possible.[2] Numerous papers or recommendations of care advise surgeons in performing open or laparoscopic surgeries during the COVID-19 pandemic.[3],[4]

In the current situation, hospital beds in many hospitals are overloaded with COVID-19–infected patients, and elective surgeries are reduced.[4] Hong Kong also similarly suffers, and many women with fibroids and adenomyosis were not treated surgically in hospitals.

This letter presents an alternative surgical treatment of fibroids and adenomyosis in women in times of COVID-19. It is the noninvasive high-intensity focused ultrasound (HIFU) ablation for fibroids and adenomyosis, with good treatment outcome.[5] Patients can also be treated as day surgery in a clinic.[6] HIFU ablation advantages include day-only surgery, bloodless, no need for pneumoperitoneum, early postoperative recovery, no need for hospital stay, and fewer complications. Thus, it may significantly reduce the risk of viral transmission because it is without blood loss, pneumoperitoneum, and general anesthesia while working in a clinic. The clinic we set up in Hong Kong has successfully treated more than 150 patients during the year of the COVID-19 pandemic. Our experience is further endorsed by HIFU centers in China and Asia Pacific countries where HIFU services are available.

This ongoing pandemic and possible future viral pandemic show that this noninvasive HIFU treatment for fibroids and adenomyosis should be recommended wherever the service is available. Finally, our clinic's current experience shows that HIFU ablation for fibroids or adenomyosis does not have an increased risk of transmission of SARS-CoV-2, provided all preventive measures are taken by staff within the clinic and theater. HIFU ablation should be the preferred mode of treatment in the future, especially in a pandemic when running short of hospital beds.

Financial support and sponsorship

Nil.

Conflicts of interest

Prof. Felix Wu Shun Wong, an editorial board member at Gynecology and Minimally Invasive Therapy, had no role in the peer review process of or decision to publish this article. Dr. Thomas Li declared that there is no conflict of interest in writing this letter.



 
  References Top

1.
Khoiwal K, Chaturvedi J. Gynecological surgeries during COVID-19 pandemic: A laparoscopist's viewpoint. Gynecol Minim Invasive Ther 2021;10:69-70.  Back to cited text no. 1
  [Full text]  
2.
Zhang W, Du RH, Li B, Zheng XS, Yang XL, Hu B, et al. Molecular and serological investigation of 2019-nCoV infected patients: Implication of multiple shedding routes. Emerg Microbes Infect 2020;9:386-9.  Back to cited text no. 2
    
3.
Chiofalo B, Baiocco E, Mancini E, Vocaturo G, Cutillo G, Vincenzoni C, et al. Practical recommendations for gynecologic surgery during the COVID-19 pandemic. Int J Gynecol Obstet 2020;150:146-50.  Back to cited text no. 3
    
4.
Mallick R, Odejinmi F, Clark TJ. Covid 19 pandemic and gynaecological laparoscopic surgery: Knowns and unknowns. Facts Views Vis Obgyn 2020;12:3-7.  Back to cited text no. 4
    
5.
Shui L, Mao S, Wu Q, Huang G, Wang J, Zhang R, et al. High-intensity focused ultrasound (HIFU) for adenomyosis: Two-year follow-up results. Ultrason Sonochem 2015;27:677-81.  Back to cited text no. 5
    
6.
Zhang L, Wong FW. A high-intensity focused ultrasound surgery theater design in a private clinic. Gynecol Minim Invasive Ther 2020;9:1-5.  Back to cited text no. 6
  [Full text]  




 

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