The Intra Uterine Morcellator: a new hysteroscopic operating technique to remove intrauterine polyps and myomas.

摘要

STUDY OBJECTIVE: A new hysteroscopic operating technique was compared retrospectively with conventional resectoscopy. DESIGN: Retrospective comparison (Canadian Task Force Classification II-2). SETTING: Gynecology department of a university-affiliated teaching hospital. PATIENTS: Fifty-five women, 27 with endometrial polyps and 28 with submucous myomas. INTERVENTION: Patients were treated with a prototype of the Intra Uterine Morcellator (IUM). This cutting device, 35 cm in length, was inserted into a straight working channel of a 90-mm hysteroscope. MEASUREMENTS AND MAIN RESULTS: The major advantages were ease of removal of tissue fragments through the instrument and the use of saline solution instead of electrolyte-free solutions used in monopolar high-frequency resectoscopy. The mean operating time was 8.7 minutes (95% CI: 7.3-10.1) for the removal of endometrial polyps compared with 30.9 minutes (CI: 27.0-34.8) for resectoscopy, and 16.4 minutes (CI: 12.6-20.2) for submucous myomas compared with 42.2 minutes (CI: 39.7-44.7) for resectoscopy. All procedures were uneventful. CONCLUSION: This new technique is faster, and it appears to be easier to perform. Therefore, it can be expected to result in fewer fluid-related complications and to lead to a shorter learning curve when compared with conventional resectoscopy.