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Uterine viability in the baboon after ligation of uterine vasculature: a pilot study to assess alternative perfusion and venous return for uterine transplantation. Fertil Steril 2017 Apr;107(4):1078-1082

Date

03/12/2017

Pubmed ID

28283262

DOI

10.1016/j.fertnstert.2017.01.014

Scopus ID

2-s2.0-85014525739 (requires institutional sign-in at Scopus site)   18 Citations

Abstract

OBJECTIVE: To assess, in two separate groups of baboons, uterine viability after ligation of the uterine veins and uterine viability after ligation of both the uterine arteries and veins, respectively.

DESIGN: Prospective, observational study.

SETTING: Baboon breeding colony.

ANIMAL(S): Six naïve female Papio hamadryas baboons with indicators of normal reproductive function.

INTERVENTION(S): Three baboons underwent surgical interruption of the uterine veins bilaterally, and three baboons underwent surgical interruption of the uterine arteries and the uterine veins bilaterally. All baboons also underwent colpotomy, cervico-vaginal reanastomosis, and intraoperative near-infrared fluorescence imaging after vessel ligation. In the postoperative period, transabdominal sonography, vaginoscopy, and endocervical biopsy were performed on all animals.

MAIN OUTCOME MEASURE(S): Postoperative uterine and ovarian viability.

RESULT(S): Near-infrared imaging confirmed intraoperative perfusion of the uterus and cervico-vaginal anastomosis in all cases. In all subjects, sonography revealed normal uteri, and vaginoscopy revealed well-healed anastomoses. Endocervical biopsies (five of six) demonstrated pathologically normal endocervical tissue without evidence of necrosis. Cyclical sex skin turgescence and menstruation were unanimously observed.

CONCLUSION(S): Disruption of bilateral uterine vessels does not affect uterine or ovarian viability in the baboon. Bilateral uterine artery and vein ligation furthers development of a minimally invasive approach to donor hysterectomy.

Author List

Shockley M, Arnolds K, Beran B, Rivas K, Escobar P, Tzakis A, Falcone T, Sprague ML, Zimberg S

Author

Benjamin D. Beran MD Assistant Professor in the Obstetrics and Gynecology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Animals
Female
Hysterectomy
Ligation
Models, Animal
Necrosis
Ovary
Papio hamadryas
Perfusion Imaging
Pilot Projects
Regional Blood Flow
Tissue Survival
Uterine Artery
Uterus
Veins