Use of the PumpVac Plus Suction Irrigation System at Gynecologic Endoscopy

At both laparoscopy and hysteroscopy, controlled movement of fluids is necessary. In addition, at laparoscopy, suctioning of accumulated smoke from lasers or electrosurgery is an essential venting technique to enhance visibility. This chapter will describe and discuss a unique, simple, cost-effective system that can be used for both hysteroscopy and laparoscopy to accomplish movement of fluids and management of smoke. Aquadissection or hydrodissection has been used for many years as an adjuvant to operative laparoscopy.' It has been found useful for operative laparoscopic treatment of conditions such as endometriosis, pelvic adhesions, and tubal obstructron. Most current systems are cumbersome, wastefully use large volumes of fluid, and often require a mechanical pump for pressurizing the fluid suction and irrigation systems. Usually, during combined laparoscopy and hysteroscopy, a separate system is used for accomplishing uterine distention when fluids are used for the hysteroscopic portion of surgery. The Pump Vac Plus can be used for both hysteroscopic distention and laparoscopic suction and irrigation. This article will describe our techniques for using the Pump Vac for both of these endoscopic approaches.