What are fibroids?
The uterus, or womb, is the primary reproductive organ of the female body. Fibroids are the most frequently seen tumors of the female reproductive system. These are firm, compact tumors that are made of smooth muscle cells and fibrous connective tissue that develop in the uterus. It is estimated that between 20 to 50 percent of women of reproductive age have fibroids.
In more than 99 percent of fibroid cases, the tumors are benign (non-cancerous. They may range in size, from the size of a pea to the size of a football.
Myomectomy is the surgical removal of fibroids from the uterus. It allows the uterus to be left in place and, for some women who are finding difficulty in getting pregnant, may increase chances of pregnancy.
Surgical methods for myomectomy include:
- Hysteroscopy, which involves inserting a lighted viewing instrument through the vagina and into the uterus. No cuts are made on the abdominal skin. Hysteroscopic myoma resection is used for fibroids growing close to the inner lining of the uterus (called submucous fibroids)
- Laparoscopy, which uses a lighted viewing instrument called a telescope and a surgical camera, and one or more small cuts (incisions) in the abdomen. This is used for fibroids growing over the outer surface of the uterus (called intramural or subserous fibroids).
- Laparotomy, which uses a large cut on the abdomen without using any advanced surgical and imaging equipment
Though fibroids can be removed by laparoscopy or by laparotomy, laparoscopy has become the preferred route for this surgery because of several advantages like
- Smaller and more cosmetic scars
- Less Blood Loss
- Early discharge from hospital
- Early recovery and return to work, and many more
One of the main concerns in fibroid surgery is the challenge of being able to minimize the blood lossin myomectomy, as fibroids are usually quite richly supplied with blood vessels.
It is common practice to inject a vasopressor solution into the fibroid, below its external covering called the pseudocapsule. This solution acts around the blood vessels supplying the fibroid, before taking an incision on the fibroid. This vasopressor solution causes a temporary vasoconstriction, or shrinkage of blood vessels over the fibroid, thereby minimising the blood loss after starting surgery. This injection is presently done by using a 30cm long, 5mm wide injection needle.
However, the use of a vasoconstrictive agent also carries an inherent risk. If this vasoconstrictive solution were to be injected, by mistake into a blood vessel rather than around the blood vessel, it would directly cause its action on the vascular network of the entire body, with serious life threatening complications involving vital organs like the heart, causing cardiac arrest or rhythmic disturbances. It could also involve the brain causing permanent paralysis.
At present, there is no technology available to ensure that this injection does not enter the blood circulation during surgery. Hence, occasional complications have been reported during laparoscopic myomectomy at this precise point of time in surgery.
The present invention, a Visual Vasopressor Injection Needle (VVIN) addresses exactly this problem, allowing the surgeon to detect an inadvertent intravascular placement of his or her injection needle BEFORE the solution is injected into the body.
