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Vulvar Condyloma Wide Local Excision with use of SONOPET

Ultrasonic aspiration (UA) is commonly used for resecting intracranial tumors, as they allow for debulking of large tumors, while avoiding damage to adjacent brain tissue. There are multiple models on the market from several different manufactures, Integra’s CUSA, Söring’s LEVICS, and Stryker’s SONOPET, being the three most studied (A Borges1, 2019).

This technique is also highly effective when employed for excisions in anogenital cases (Henzi, 2019), and is growing in popularity. Some of the most common diseases treated with SONOPET include VIN 2 (41.79%) and VAIN 2 (40.62%) (Henzi, 2019). Patient’s can have complete excision of the lesion with the benefit of less disfiguration and scarring compared to traditional wide local excision (WLE), with the most commonly reported complication being post-operative pain. Because SONOPET allows for aspiration and collection of fragmented tissue, tissue diagnosis can be achieved and has found to be consistent with pre-operative biopsy diagnosis. However, since margins cannot be confirmed it is not recommended when malignant disease is suspected (Miller, 2002).

The purpose of this video is to briefly review assembly and use of the Striker SONOPET for excision of vulvar lesions.

Vulvar Condyloma Wide Local Excision
Removal of vulvar lesion with improved patient satisfaction and cosmetic outcomes.
Malignancy/ suspected malignancy
Construction of SONOPET device is covered in video.
Workup includes patient history, biopsy of suspicious lesions, and may include trial of topical agents prior to surgery depending on patient preference.
N/A
Patient’s can have complete excision of the lesion with the benefit of less disfiguration and scarring compared to traditional wide local excision (WLE), with the most commonly reported complication being post-operative pain.
This should be considered a low risk procedure.
None.
N/A
A Borges1, L. P. (2019). 370 Ultrasonic surgical aspirator (Sonopet®) for anogenital intraepithelial neoplasia. Surgical Techniques and Perioperative Man. Henzi, S. K. (2019). Ultrasonic aspiration in neurosurgery: comparative analysis of complications and outcome for three commonly used models. Acta Neurochir(161), 2073–2082 . Miller, B. E. (2002). Vulvar intraepithelial neoplasia treated with cavitational ultrasonic surgical aspiration. Gynecol Oncol.

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