HIFU is the abbreviation of High Intensity Focused Ultrasound which is using high intensity ultrasound that focused on one spot to create heat. The heat will go through abdomen, bladder and uterus to heat the uterine fibroids and adenomyosis up to 60 Celsius degrees to destroy the protein of cells which will make fibroids and adenomyosis to show coagulation necrosis. Those damaged cells will be absorbed by normal myometrium to achieve an effect of ablation and easement of symptom.
For the most common tumor that women have-- uterine fibroids were usually dealt with surgery such as conventional surgery, laparoscopic myomectomy or da Vinci surgical system that have to cut abdomen open or small cut outs on the belly once the symptom emerged or the tumors are too huge. The recovery of surgery requires several weeks or months with potential adhesion risk. Surgeries, blood transfusion, intubation anesthesia, wounds on the abdomen or even approaching menopause are one of the reasons that women didn’t want to have conventional surgery.
The most amazing thing about HIFU is that it can penetrate your abdomen and uterus but didn’t cause any harm to them. The point that focused is about 60-80 Celsius degrees, but human protein will be damaged when the Celsius is up to 56 degrees. That is how HIFU work on human body to ablate uterine fibroids and adenomyosis step by step without harming the surrounding tissue. HIFU is popular by women as a new treatment for uterine fibroids, adenomyosis, endometriosis and etc.
Department of Obstetrics and Gynecology of Kaohsiung Medical University Hospital introduced HIFU equipment and established the first HIFU Therapy Center in southern Taiwan in April 2015 by Vice Superintendent Jeng Cherng-Jye. KMUH becomes the greatest HIFU Therapy Center in 2016. In 2017, KMUH’s patients account more than 50% of total HIFU therapy centers from nationwide.
In addition to clinical treatments, there are more than 10 SCI papers and essays published from both nation and overseas’ conferences in the past 3 years. Vice Superintendent of KMUH Jeng Cherng-Jye is the founding chairman of Taiwan Association of HIFU Therapy in Gynecology which was established by hospitals from all over Taiwan. Professor Jeng Cherng-Jye was elected as the Vice President of International Society of Minimally-Invasive and Noninvasive Medicine in 2017. We will also apply for national SNQ awards and establish HIFU therapy centers in Taipei, Suzhou, Shanghai and Hangzhou in the future. Asia-Pacific HIFU Therapy Training Center will also be established in the near future.
Services and Advantages:
HIFU basically is a non-invasive surgery. It uses high intensity focused ultrasound to penetrate the skin of abdominal area and bladder which will make uterine fibroids and adenomyosis into the situation of coagulation necrosis with the heat of 60-80 Celsius degrees. Those necrotic cells will be absorbed by normal myometrium gradually.
Before treatment, patient will remove the hair and fat in abdominal area that can make the ultrasound probe can attach to the skin very well without air in the middle. With air between probe and skin, heat from ultrasound will burn the skin.
After removing the hair and fat, patient will face down towards the bed and abdominal skin will be soaked in cool water with 15 Celsius degrees. Nurse will give patient an intravenous infusion under the monitor of anesthesiologist and nurse for vital signs, sedation and analgesics.Low dose of anesthesia will be given to the patient when it’s needed. But this is called conscious anesthesia for patient not going into a situation of deep anesthesia, otherwise patient will not be conscious enough to react to the burn of abdomen skin and nerves.
Gynecologist will start to use ultrasound to locate the focal lesion and compare it with preoperative MRI to confirm the range of focal lesion from left to right with sections to conduct the following therapy. Since the air in the intestines will make the heat of HIFU to burn intestines, we will make bladder blows up or put water bag under patient’s abdomen to move intestines if the focal lesion is blocked by them.
Depends on patient’s tolerance, doctors can choose to fire one second of sonication and rest for 2 seconds or fire 2 seconds of sonication with 3-5 seconds’ rest. It can be determined ablation accomplished with a clump or a change of grayscale on the ultrasound image which also means it can move on to a new area of treatment. Total treatment is about 2-3 hours. But huge or multiple tumors will cost 4-5 hours or with 2-3 times of treatments, because a continuously hours of treatment is tough for both medical specialists and patient.