Magdalene Karon
Dr. Karon’s Pelvic Reconstructive Surgery and Research Center, Lexington, KY
Title: Regenerative healing as it applies to gynecologic surgery using mesenchymal stem of placental/amniotic origin
Biography
Biography: Magdalene Karon
Abstract
Ten applications in gynecologic surgery and one in obstetrics will be presented.
The unique biologic structure and components of the placental tissue coupled with the immune privileged response provide an ideal choice for homologous clinical use. The pluripotent mesenchymal cells in the presence of an acellular matrix (scaffold) have the capability to start the regenerative process in any tissue they are placed next to. With the addition of growth factors and mediators also present in the placental/amniotic tissue, reconstruction begins. The process is quite different than healing by scar tissue formation and foreign body reaction such as happens with synthetic meshes and other devices. TGF-β and its receptor expression by fibroblasts promote reconstruction rather than scar and adhesion formation. Ani microbial properties, angiogenesis and interleukin-1 receptor antagonist which modulate pain secondary to inflammation are additional advantages.
The use of human cells, tissue and cellular/tissue-based products are considered “on the label” by the FDA according to the Regulatory Guidance issued by them in November 2017, as long as we follow homologous use and minimal manipulation.
Other specialties such as orthopedics, ophthalmology, and wound care centers have adopted the use of placental/amniotic tissue to complement healing. We present here the first applications in Ob/Gyn.
We will show intraoperative pictures from laparoscopic robotically assisted surgeries such as sacrocolpopexy and para vaginal defect repair for pelvic prolapse using biologic matrix patch. Also, robotic laparoscopic myomectomy using viable cryopreserved umbilical tissue. We will present how amniotic fluid allograft injected into an ovary after endometrioma resection can raise the Anti- Mullerian Hormone by 167%. Pudendal block for neuralgia, fistula repair and other applications will follow.