220: Hysteroscopic Morcellation, a New Technique for the Removal of Endometrial Polyps and Submucous Myomas

Abstract

The purpose of this pilot study was to assess the performance and safety of a new hysteroscopic operating technique. An observational study. Four European university-affiliated training hospitals. Fifty patients with endometrial polyps and submucous myomas. A device similar to an arthroscopic surgery blade, the Hysteroscopic Morcellator, 35 cm in length, was inserted in to a straight working-channel of a 9 mm hysteroscope. The major advantages are: the use of saline solution instead of the electrolyte-free solutions used in monopolar high-frequency resectoscopy and the ease of removal of the tissue fragments through the instrument. The mean operating time was 5.6 min. for polyps and 15.2 min. for myomas. The overall mean operating time was 9.8 min. The mean amount of fluid deficit (saline) was 196 mL for polyps and 871 mL for myomas. The overall mean fluid deficit was 448 mL. The mean surgeons rating (VAS, range 1=poor-10=excellent) score of easiness and performance of the technique was 9.2 for polyps, 7.3 for myomas and 8.4 overall. Four complications were reported. These included abdominal pain (2), bleeding (1), and fluid overload (1). This new technique for the removal of endometrial polyps and submucous myomas offers a safe and effective alternative to conventional electrical resectoscopy.