AUTHOR: DR. RAMÓN M. BOTACIO P.
Keywords:
HPV: Human Papillomavirus
HPVI: Human Papillomavirus Infection
DNA: Deoxyribonucleic Acid
CIN: Cervical Intraepithelial Neoplasia
Electrosurgery is a modern procedure that allows us to eradicate lesions and transformation zones (areas where cancer begins) in the cervix. Today, we have the knowledge, equipment and modern techniques that make this new technology effective.
Electrosurgery is performed under Colposcopic vision and high precision. It consists of the removal of the lesion and the transformation zone ( the area where cervical cancer begins).
We currently have a wide range of modern surgical techniques, to perform electrosurgery, backed up by the experience and dexterity of the Certified Colposcopist Physician, to ensure that it is an effective and innocuous procedure (without hurting).
The main goal of electrosurgery is to prevent cancer of the Lower Genital Tract: cervix, vagina, vulva and anus, by the timely eradication of premalignant lesions.
This new procedure allows us to perform effective prevention in the Lower Genital Tract. Also, the patient will gradually improve the pelvic inflammatory processes including chronic inflammation of the vagina (vaginitis), vulva (vulvitis), and urinary tract; Improving their quality of life.
- Is ambulatory
- It doesn’t cause pain
- Local anesthesia is used
- Allows high recuperation rate
- Takes place in 10 to 15 minutes
- It allows eradicating lesions in depth and extension
- Samples for histopathological studies can be taken
- Once the procedure is done, the patient can travel to different parts of the country
- LESIONS IN THE CERVIX:
- Polyps
- Endocervical fibroma.
- Glandular Eversion.
- Papillomavirus Lesions
- Mild dysplasia (CIN I)
- Moderate dysplasia (CIN II)
- Severe dysplasia (CIN III)
- Carcinoma in situ
VAGINAL, VULVA, PERINEUM AND PERIANAL LESIONS
- Papillomavirus lesions (Flat and Condyloma)
- Premalignant neoplasms
Currently, we have the specialized knowledge and modern techniques required for electrosurgery to be effective and innocuous (without damage). After the procedure, the cervix (vagina, vulva or anus) will have an almost 100% resurfacing, healing and tissue regeneration; Acquiring its anatomy, histology, and normal function.
The modern concept of electrosurgery, allows us to avoid cervix and uterus mutilating surgeries (cones with scalpel, hysterectomy).
As previously described, nowadays, we have important advances for performing electrosurgeries, which has substantially favored patients looking for new pregnancies.
Currently, if the patient meets the established requirements for electrosurgery, a healthy and fortified cervix is guaranteed, two months after the procedure, with anatomical, histological and normal function.
Recent studies conducted worldwide and, also, based on our own professional experience (INACOLP protocol), based on the electrosurgeries performed by Certified Colposcopist Physicians, with extensive experience and dexterity, applying modern techniques, does not affect future pregnancies; This, in reference to complications such as abortions and premature births, which may be related to situations caused by other types of issues unrelated to electrosurgery.
INDICATORS REQUIRED FOR THE ELECTROSURGERY SUCCESS
A highly specialized work team is required, consisting of a Certified Colposcopist Physician and Clinical Assistants with Colposcopy Training. In this way, it will be possible to offer professional care demanded by modern medicine.
HIGH RESOLUTION COLPOSCOPE
Electrosurgery is performed under Colposcopic vision, so it is imperative to have a high-resolution digital colposcope that allows us to have a precise surgical approach and avoid injuring adjacent areas.
ELECTROSURGICAL UNIT
Today, we have modern electrosurgical generators, which have the property of allowing us to do the procedure without damaging tissue. Also, to simultaneously cut and coagulate (blend), avoiding bleeding and complications during surgery.
WASTE ASPIRATOR
It is the equipment in charge of aspirating all waste material during the procedure. It is connected to the speculum that is placed in the patient to extend the vagina, through a duct that transports waste material towards the aspiration equipment.
ELECTRODES
The electrode is the instrument, that allows the performance of the surgical excision of the lesion, which may be in the cervix, vagina or vulva. Today, we have more than a dozen different electrode designs, which are selected according to the characteristics of the diagnosis and the degree of injury to be treated.
ANESTHESIA
The Colposcopist Doctor must have the knowledge, experience, and dexterity in different types of anesthesia that may be used, according to the clinical case. The anesthesia used is local, and it is applied only to the area to be treated: cervix, vagina, vulva, perineum or perianal area. Adequately selecting anesthesia and modern application techniques, assure patients an ambulatory and pain-free treatment.
- Debe ser realizada por el Médico Colposcopista idóneo titulado en la Especialidad de Colposcopía.
- Experiencia y destreza del Colposcopista en las diferentes técnicas electroquirúrgicas modernas.
- Contar con equipos de tecnología moderna: Unidad electroquirúrgica, colposcopio digital, instrumental e insumos.
- Tener dominio del conocimiento téorico-práctico en la funcionalidad de la unidad electroquirúrgica.
- Contar con los diferentes tipos de electrodos y seleccionarlos, según el diagnóstico y grado de lesión a tratar.
- Tener un amplio conocimiento sobre los tipos de anestesias y diferentes técnicas de aplicación, según el caso clínico a tratar.
- Tener un diagnóstico previo de lesión pre-invasora.
- La paciente a tratar, debe recibir la capacitación sobre la electrocirugía e indicaciones a cumplir antes, durante y después del procedimiento.
El Cumplimiento de Estos Requisitos, Garantizan una Alta Tasa de Curación y Evitan Complicaciones Propias del Procedimiento.
In INACOLP we have specialized human resources and extensive experience in Advanced Colposcopy and Pathology of the Lower Genital Tract. In addition to this, our modern technology consists of appropriate equipment, instruments, and supplies, to professionally and successfully perform electrosurgery.
In the Uterine Cervical Cancer Prevention Unit (UNIPREV), now instituted as INACOLP, we have carried out approximately 7,000 electrosurgeries, eradicating premalignant lesions, achieving effective prevention and preventing these patients from advancing to invasive cancer.
- Electrosurgery for HPV- Related Diseases of The Lower Genital Tract. Wright T. C. Ralph Richart Ferenczy Alex. 1992 Bio Vision, Incorporated.
- Virus del Papiloma Humano y Cáncer de Cuello de Útero. Carrera-Xercavins-Checa. Editorial Panamericana. 2012
- LEEP en el tracto genital inferior femenino. Toziano-Castaño-Gori. Editorial Panamericana. 2007
- Prendeville W et al Br J Obstet Gynecol. 1989; 96:1054-60
- Histopatología del cuello uterino. G. Dallenbach-Hellweg. Ediciones Journal. Second Edition. 2006
- Archivos Médicos de Actualización en Tracto Genital Inferior. Year IV, N° 8, April 2013.
- Catanon A., Sasieni P. BMJ 2012;345: 51-74
- Láser en Ginecología. Hurtado Gabino, Ojeda Jorge. First Edition, Editorial Cuellar.
- Colposcopia y Patologías del Tracto Genital Inferior. Tatti Silvio. Editorial Panamericana. 2008
- La Colposcopía y el Tratamiento de la Neoplasia Intraepitelial Cervical. Sellors John, Sankaranarayanan R. OPS 2003.
- Atlas Colpo-Cito-Histologico del Cuello de Uterino. José Editorial ASCUNE Hnos. First Edition 2010.
- Sadler L et al JAMA 2005;291:2100-6
- Lopez-Yarto M y Cols. XI International Congress of Cervical Pathology and Colposcopy. Barcelona 2002. P 243-2
- COLPOSCOPIA Texto y Atlas. E.J. Mayeaux, Jr. J. Tomas Cox Lippincott Williams & Wilkins Third Edition, 2013.