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The Intra Uterine Morcellator: a new hysteroscopic operating technique to remove intrauterine polyps and myomas
Mark Hans Emanuel1, Kees Wamsteker
1Department of Obstetrics and Gynecology, Spaarne Hospital, Haarlem, The Netherlands.
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.
