An analysis of fluid loss during transcervical resection of submucous myomas

Emanuel, Mark Hans; Hart, A. A. M.; Wamsteker, Kees; Lammes, F. B.

doi:10.1016/s0015-0282(97)00335-x

Cited by 72 publications

(36 citation statements)

References 7 publications

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“…As discussed by Emanuel et al, the diameter of an intrauterine pathology is strongly related to the operation time and to the complication rate [26]. Considering the tissue volume to be removed according to the 4/34/3πr 3 formula, the conventional monopolar loop-based resection of Ø 2, 3, and 4 cmsized myomas has respectively taken 8.4, 28.2, and 67.0 min, at a resection speed of 0.5 cm 3 /min.…”

Section: Discussionmentioning

confidence: 96%

Hysteroscopic myomectomy with the IBS® Integrated Bigatti Shaver versus conventional bipolar resectoscope: a retrospective comparative study

et al. 2014

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From June 2011 to June 2013, all hysteroscopic myoma resections at the Ospedale San Giuseppe of Milan were performed using either the IBS® or the Versapoint® bipolar resectoscope. Dilatation time of the cervical canal, resection time, fluid balance, and complete single-stage removal of the myoma have been studied. The outcome was stratified for groups of myomas larger and smaller than 3 cm. Seventy-six myomectomies were performed with the IBS® and 51 with the Versapoint®. Both groups had a similar distribution of difficult cases like G2 and larger than 3 cm myomas. The results show no difference in terms of cervical dilatation, resection time, and fluid deficit between the two groups, but, for myomas less than 3 cm and G2 myomas, the IBS® has been able to treat respectively 93.5 % (p=0.3753) and 62.5 % (p=0.5491) of cases in a single step procedure. The overall number of necessary second procedures has been statistically significantly less in the IBS® Group than in the Versapoint® Group (p=0.0067). Although no significative difference in terms of time of resection, the IBS® has proven to be able to approach all kind of submucosal myomas in a single-step procedure and in a very precise and easy way. The IBS® can be considered a valid alternative to the conventional resectoscope.

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Section: Discussionmentioning

confidence: 96%

Hysteroscopic myomectomy with the IBS® Integrated Bigatti Shaver versus conventional bipolar resectoscope: a retrospective comparative study

et al. 2014

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“…Especially for the treatment of large polyps and myomas up to 2 cm, it has several well-described advantages. As discussed by Emanuel et al, the diameter of an intrauterine pathology is strongly related to the operation time and to the complication rate [19]. Considering the volume calculation of the tissue to remove by the formula 4/3πr 3 , we need 8.4 min to resect 2 cm, 28.2 min for 3 cm and 67.0 min for 4 cm at a resection speed of 0.5 cm 3 /min for a conventional monopolar loop.…”

Section: Discussionmentioning

confidence: 99%

IBS® Integrated Bigatti Shaver versus conventional bipolar resectoscopy: a randomised comparative study

Bigatti¹,

Ferrario²,

Rosales³

et al. 2011

Gynecol Surg

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Conventional bipolar resectoscopy is widely recognized as the first choice for major hysteroscopic operations. We recently proposed an alternative approach to operative hysteroscopy called Integrated Bigatti Shaver (IBS®) that improves visualization during the procedure, reducing several problems of conventional resectoscopy such as fluid overload, water intoxication, uterine perforation and long surgeon's learning curve. In cooperation with Karl Storz GmbH & Co., we created a new shaving system that, when introduced through the straight operative channel of a panoramic 90°optic, allows performance of many major hysteroscopic operations. The present randomised comparative study was designed to compare 50 cases performed with conventional bipolar resectoscope with 50 cases performed with the IBS®. Several types of major intrauterine pathologies such as polyps and submucosal myomas (according to ESGE classification) were included in the study. Two cases of via falsa were reported. In one case, the procedure was immediately stopped with no further complication for the patient, whereas in the second patient, the complication did not compromise the operative course. Dilatation time, overall procedure time, resection time and fluid balance were carefully monitored during each procedure in the two groups. The aim of the study was to compare the two techniques to confirm several advantages offered by the IBS® such as reduced dilatation of the cervix, better visualization during the procedure because tissue chips are removed at the same time as the resection, no need for coagulation or cutting current, utilization of normal saline and a much faster learning curve.

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“…1). This staging correlates with rates of complete fibroid resection [16,17] and risk of fluid absorption [18]; for example, the rates of incomplete resection and fluid overload are highest for FIGO L2.…”

Section: Hysteroscopic Myomectomymentioning

confidence: 99%

Endoscopic Treatment and Power Morcellation of Uterine Fibroids

Dixit

Jesner

Modarres

2016

Curr Obstet Gynecol Rep

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Although a variety of pharmacological and radiological treatment options are available, surgery in the form of myomectomy or hysterectomy provides a quick and effective relief of many symptoms, albeit with attendant surgical risks. In this article, we discuss endoscopic surgical treatments, their relative benefits, and their risks, including risk of morcellation. Patient selection and preoperative preparation for various surgical approaches is discussed. Overall, the evidence base for surgical treatments, including endoscopic, is weak, and, therefore, a pragmatic approach is outlined.

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An analysis of fluid loss during transcervical resection of submucous myomas

Cited by 72 publications

References 7 publications

Hysteroscopic myomectomy with the IBS® Integrated Bigatti Shaver versus conventional bipolar resectoscope: a retrospective comparative study

Hysteroscopic myomectomy with the IBS® Integrated Bigatti Shaver versus conventional bipolar resectoscope: a retrospective comparative study

IBS® Integrated Bigatti Shaver versus conventional bipolar resectoscopy: a randomised comparative study

Endoscopic Treatment and Power Morcellation of Uterine Fibroids

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