Abstract:
Falloposcopy is the endoscopic examination of the fallopian tubes, which are challenging to access due to their deep body location, small opening from the uterus, and lumen filled with plicae. We and others have developed endoscopes that are inserted through the uterus guided by a hysteroscope into the tubal ostium. To better understand how to utilize these endoscopes either as standalone devices or in concert with everting delivery balloons, a preliminary study of anatomy and mechanical behavior was performed ex vivo on porcine and human fallopian tubes. Segments of fallopian tubes from the isthmus, ampulla and infundibulum were inflated with saline either to bursting or held at sub-burst pressures with saline or a saline-filled balloon. Formalin fixed, paraffin embedded tissue sections stained with Masson\'s trichrome were examined for damage to the mucosa and muscularis. Porcine fallopian tubes tolerated saline pressurization at 15 psi for 1 minute without morphological damage. Balloon inflation to 15 psi caused no apparent damage to the muscle layer or rupture of the fallopian tube, but balloon movement within the tube can denude the mucosal epithelial layer. Human fallopian tubes averaged higher burst pressure values than porcine tubes. Under pressurization, the external tube diameter expanded by minimal to moderate amounts. Human and porcine tissues were similar in histological appearance. These studies suggest that moderate pressurization is acceptable but will not appreciably expand the fallopian tube diameter. The results also indicate that pigs are a reasonable model to study damage from falloscopy as seen in human tissue.
摘要:
输卵管镜检查是对输卵管的内镜检查,由于它们的身体位置很深,很难进入,子宫的小开口,内腔充满了皱褶。我们和其他人已经开发了内窥镜,该内窥镜在宫腔镜的引导下通过子宫插入输卵管口。为了更好地了解如何将这些内窥镜用作独立设备或与外翻输送气球配合使用,对猪和人输卵管进行了体外解剖和力学行为的初步研究。来自峡部的输卵管段,壶腹和漏斗用盐水充气,以破裂或用盐水或充满盐水的球囊保持在爆裂压力下。福尔马林固定,用Masson三色染色的石蜡包埋的组织切片检查对粘膜和肌层的损伤。猪输卵管在15psi下耐受盐水加压1分钟而没有形态学损伤。气球充气至15psi没有对肌肉层造成明显的损伤或输卵管破裂,但是球囊在导管内的运动可以穿透粘膜上皮层。人输卵管平均爆裂压力值高于猪输卵管。在加压下,外部管直径膨胀最小到中等量。人和猪组织在组织学外观上相似。这些研究表明,适度的加压是可以接受的,但不会明显扩大输卵管直径。结果还表明,猪是研究从人体组织中观察到的视神经损伤的合理模型。