First experience of a modified device for excision of the endocervix in a reverse cone during laparoscopic...

The objective of this study was to evaluate the performance and safety of a modified unipolar electrode developed for excision of the endocervix in a reverse cone pattern during laparoscopic supracervical hysterectomy (LSH) to reduce the occurrence of persistent vaginal bleeding after the procedure. The study is a prospective pilot trial performed at a Norwegian university teaching hospital. Excision of the endocervix was performed with the unipolar electrode immediately after the amputation of the cervix during LSH in 23 consecutive women referred to the department for hysterectomy on the basis of a benign condition. The mean duration of the inverse conization was 61.9 seconds (SD 24.7). The excision of the endocervix in a reverse cone pattern was reported to be without technical problems in 22 procedures (96%). The results of this pilot study indicate that the modified device is safe, technically easy to use, and prolongs the duration of the LSH procedure insignificantly. Long-term effects of the device will be evaluated in a prospective randomized trial.