63: Hysteroscopic Morcellation Versus Conventional Resectoscopy, a Randomized Controlled Trial Comparing Both Techniques in the Hands of Ob/Gyn Residents in Training

Abstract

Study ObjectiveThe purpose of this randomized controlled trial is to compare the learning curve of residents in training for both techniques.InterventionThe hysteroscopic morcellator is a device similar to an arthroscopic surgery blade inserted into 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. Sixty patients with endometrial polyps and/or submucous myomas type 0 were recruited and randomized in two groups after informed consent. In group A patients were treated by residents with the new hysteroscopic morcellator and in group B patients were treated by residents with conventional resectoscopy.Measurements and Main ResultsPrimary outcome measures were the assessment of the ease of use and performance measured by operating time, fluid deficit, number of instrumentation insertions and subjective surgeon satisfaction scores of the residents and their trainers. Secondary outcome measures were complications in terms of performance, bleeding and TUR-syndrome. The preliminary results of the comparison of outcome measures in both groups will be presented.ConclusionThe new technique of hysteroscopic morcellation for the removal of endometrial polyps and submucous myomas may offer a safe and effective alternative to conventional resectoscopy with a shorter learning curve as it seems easier to perform. Additionally, the implementation of hysteroscopic surgery into daily gynecologic practice, which is a matter of concern, may accelerate with this new introduced technique. Study ObjectiveThe purpose of this randomized controlled trial is to compare the learning curve of residents in training for both techniques. The purpose of this randomized controlled trial is to compare the learning curve of residents in training for both techniques. InterventionThe hysteroscopic morcellator is a device similar to an arthroscopic surgery blade inserted into 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. Sixty patients with endometrial polyps and/or submucous myomas type 0 were recruited and randomized in two groups after informed consent. In group A patients were treated by residents with the new hysteroscopic morcellator and in group B patients were treated by residents with conventional resectoscopy. The hysteroscopic morcellator is a device similar to an arthroscopic surgery blade inserted into 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. Sixty patients with endometrial polyps and/or submucous myomas type 0 were recruited and randomized in two groups after informed consent. In group A patients were treated by residents with the new hysteroscopic morcellator and in group B patients were treated by residents with conventional resectoscopy. Measurements and Main ResultsPrimary outcome measures were the assessment of the ease of use and performance measured by operating time, fluid deficit, number of instrumentation insertions and subjective surgeon satisfaction scores of the residents and their trainers. Secondary outcome measures were complications in terms of performance, bleeding and TUR-syndrome. The preliminary results of the comparison of outcome measures in both groups will be presented. Primary outcome measures were the assessment of the ease of use and performance measured by operating time, fluid deficit, number of instrumentation insertions and subjective surgeon satisfaction scores of the residents and their trainers. Secondary outcome measures were complications in terms of performance, bleeding and TUR-syndrome. The preliminary results of the comparison of outcome measures in both groups will be presented. ConclusionThe new technique of hysteroscopic morcellation for the removal of endometrial polyps and submucous myomas may offer a safe and effective alternative to conventional resectoscopy with a shorter learning curve as it seems easier to perform. Additionally, the implementation of hysteroscopic surgery into daily gynecologic practice, which is a matter of concern, may accelerate with this new introduced technique. The new technique of hysteroscopic morcellation for the removal of endometrial polyps and submucous myomas may offer a safe and effective alternative to conventional resectoscopy with a shorter learning curve as it seems easier to perform. Additionally, the implementation of hysteroscopic surgery into daily gynecologic practice, which is a matter of concern, may accelerate with this new introduced technique.