Nouvelle technique en hystéroscopie : les morcellateurs hystéroscopiques

Garbin, O.; Schwartz, Laurel

doi:10.1016/j.gyobfe.2014.10.002

Cited by 6 publications

(4 citation statements)

References 18 publications

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“…Regarding fluid deficit, the absorption of dilatation fluid may increase with the prolongation of operation time [ 2 ], and compared with traditional electrosurgery, it was true that the hysteroscopic morcellation took less time during the operation, but we found no difference in fluid deficits between the 2 surgical approaches. On the one hand, with regard to the operation time, both procedures were related to abnormal intrauterine volume, and the larger the intrauterine lesion, the longer the time required, whether it was endometrial polyps or fibroids.…”

Section: Discussionmentioning

confidence: 68%

“…In fact, with the development of minimally invasive gynecological surgery, conventional resectoscopy of endometrial polyps has become the criterion standard for treatment, and its surgical success rate was also relatively high. For intrauterine tissue pulverization and suction technology, although the TRUCLEAN system overcame the problems of the electric cutting method, such as steam bubbles generated by electric heating of uterine dilatation fluid or excised tissue, and incomplete excision, which can lead to surgical failure, it has also created new problems that reduce the success rate of surgery, such as inability to enter the uterine cavity [ 14 ] and inability to use hysteroscopic morcellation for hard fibroids [ 2 ]. In terms of complications, life-threatening complications such as fluid overload, uterine perforation, and bleeding cannot be completely eliminated regardless of the surgical option, although these are uncommon with the use of hysteroscopic morcellation [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…The postoperative recurrence rate is low, so it is widely used in clinical practice. In recent years, with the attention paid to fertility recovery after endometrial polypectomy, thermal radiation generated during electroresection has also been discussed, mainly because radiant heat can damage the deep muscle tissue of the lesion site and the surrounding normal endometrium [ 2 ]. The heat generated by electric resection can increase the temperature of the distention fluid and affect the endometrium, thus increasing the risk of intrauterine adhesion and reducing the postoperative pregnancy rate.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Hysteroscopic Morcellation Versus Resectoscopy in Treatment of Patients with Endometrial Lesions: A Meta-Analysis

Ren¹,

Huang

Wang

et al. 2022

Med Sci Monit

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Background Hysteroscopic surgery has been widely used in clinical practice for more than 30 years due to its advantages of less trauma, less bleeding, and direct vision. The aim of this study was to compare hysteroscopic morcellation versus conventional resectoscopy for removal of endometrial lesions. Material/Methods For the database search, we used the keywords “morcellator,” “morcellators,” “morcellate,” “morcellation,” and “morcellated” combined with “hysteroscopy,” “uteroscope,” and “transcervical”. The last search was conducted on February 1, 2022. Randomized controlled trials (RCTs) were included in the meta-analysis. Results According to our retrieval scheme and the inclusion and exclusion criteria, we found 6 studies including 565 patients. For enumeration data, we calculated the effect size as relative risk (RR) and 95% confidence interval (95% CI), while for quantitative data we used the weighted mean difference (WMD) and 95% confidence interval (95% CI). There was no significant difference between success rate of hysteroscopic morcellation and conventional resectoscopy (relative risk and 95% confidence interval 1.05(0.97,1.13); P =0.232). Procedure time was also shorter with hysteroscopic morcellation, the procedure time of the hysteroscopic morcellation group was 3.43 min shorter compared with the conventional resectoscopy group, and the operating time in the hysteroscopic morcellation group was 2.81 min shorter. In terms of fluid deficit, there was no statistically significant difference in fluid loss between the 2 groups ( P =0.209). Conclusions Hysteroscopic morcellation is associated with a shorter procedure time and operative time among patients with endometrial lesions compared with resectoscopy.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of Hysteroscopic Morcellation Versus Resectoscopy in Treatment of Patients with Endometrial Lesions: A Meta-Analysis

Ren¹,

Huang

Wang

et al. 2022

Med Sci Monit

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“…The present findings are consistent with the findings of Ren (11), who observed a considerable reduction in the operating time for submucous myomas in the morcellator group. According to Garbin and Schwartz (24), the Myo-Sure device was utilized in 14 patients with a median age of 40.5 minutes, resulting in a mean operation time of 9.33 ± 1.22 min as opposed to 29.32 ± 3.23 min.…”

Section: Discussionmentioning

confidence: 99%

Comparing Hysteroscopic Morcellation with Bipolar Resectoscope for Treating leiomyoma

2023

jjoas-n

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Background: Approximately 60 to 84% of submucosal myomas cause dysmenorrhea and infertility, and the majority of them can cause severe clinical symptoms such as abnormal uterine hemorrhage and menorrhagia. The most effective method for treating submucous fibroid cysts is a bipolar resectoscope.Patients and Methods: The study included 50 women who presented with fibroid. Each patient was submitted to detailed history taking, clinical examination, and laboratory evaluation. The patients in this study were divided into group I: 25 patients with fibroid treated by morcellation and group II: twenty-five patients with fibroid treated by resection. Results: Patients treated with resection significantly increased operating time, total fluid deficit, and number of insertions than patients treated with morcellation. Conclusion: Sub-mucous fibroid may be a case of abnormal uterine bleeding, infertility, and recurrent pregnancy loss; hysteroscopic myomectomy is the gold standard technique for the treatment of cases.

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Randomized Study Comparing a Reusable Morcellator with a Resectoscope in the Hysteroscopic Treatment of Uterine Polyps: The RESMO Study

Stoll¹,

Lecointre²,

Meyer³

et al. 2021

Journal of Minimally Invasive Gynecology

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Study Objective: To compare a reusable hysteroscopic morcellator and standard resectoscopes in the hysteroscopic management of uterine polyps. Design: Single-center randomized prospective single-blind trial (resectoscope-morcellator study). Setting: Centre M edico-chirurgical Obst etrique teaching hospital, Strasbourg University Hospitals, France. Patients: All patients presenting with a single endometrial polyp of size 1 cm or larger. Interventions: After consent, the patients were randomized into 2 groups: hysteroscopic morcellation (HM) group or standard resection (SR) group. Office-based review hysteroscopy was performed 6 weeks to 8 weeks after surgery. Primary end point: time of morcellation or resection. Secondary outcomes: total operating time (minutes), volume of fluid used (mL), fluid deficit (mL), number of morcellator or resectoscope insertions, operator comfort (visual analog scale: 0 to 10) and quality of vision (0 to 5), perioperative complications, completeness of resection, need to convert to another technique, pain assessment (visual analog scale), and length of hospitalization. At review hysteroscopy, we noted whether the resection or morcellation had been effective and if synechiae were present or absent. Statistical analyses followed Bayesian methods. Measurements and Main Results: Ninety patients were randomized: 45 in the HM group and 45 in the SR group. The average size of polyps at hysteroscopy was 13.3 mm. Morcellation time was lower than resection time (6.1 minutes vs 9 minutes; p [HM < SR] = .996). This also applied to total operating time (12.7 minutes vs 15.6 minutes; p [HM < SR] = .985), number of device insertions (1.50 vs 6; p [HM < SR] > .999), volume of fluid used (766.9 mL vs 1118.9 mL; p [HM < SR] = .994), and fluid deficit (60.2 mL vs 169.8 mL; p [HM < SR] = .989). Operator comfort was better in the HM group (8.4 vs 7.4; p [HM > SR] = .999) as was visualization (4 vs 3.7; p [HM > SR] = .911, highly probable). Operative complications were higher in the SR group (5 vs 0; p [HM < SR] = .989]. One patient in the SR group died after surgery owing to an anesthetic complication (anaphylactic shock complicated by pulmonary embolism). No differences were noted between the groups for pain assessment, length of hospitalization, and outcome on review hysteroscopy.The authors declare that they have no conflicts of interest. It should be noted that some of the equipment used (integrated Bigatti shaver) was provided free of charge by Karl Storz GmbH (Tuttlingen, Germany) for the length of the study. Trial registration number: ID RCB 2015-A00450-49, registered with the French National Agency for Medicines and Health Products Safety as research involving human subjects on April 14, 2015.

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Nouvelle technique en hystéroscopie : les morcellateurs hystéroscopiques

Cited by 6 publications

References 18 publications

Comparison of Hysteroscopic Morcellation Versus Resectoscopy in Treatment of Patients with Endometrial Lesions: A Meta-Analysis

Comparison of Hysteroscopic Morcellation Versus Resectoscopy in Treatment of Patients with Endometrial Lesions: A Meta-Analysis

Comparing Hysteroscopic Morcellation with Bipolar Resectoscope for Treating leiomyoma

Randomized Study Comparing a Reusable Morcellator with a Resectoscope in the Hysteroscopic Treatment of Uterine Polyps: The RESMO Study

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