Bipolar resectoscope: the future perspective of hysteroscopic surgery

Abstract

The objective of this study is to prove the effectiveness and security of bipolar resectoscope in hysteroscopic surgery. A clinic-based, prospective, non-randomised trial was conducted in Centro Florence di Chirurgia Ambulatoriale, Florence, Italy. One hundred fifty-seven women with endocavitary uterine pathologies, such as myoma, polyp, uterine septum and endometrial hyperplasia, were included in the study. Myomectomy, polypectomy, metroplasty and endometrial ablation have been done through the use of Karls Storz 26 Fr bipolar resectoscope and Autocon II 400 high-frequency unit with parameters standard selected 180 (in effect 4) for cut and 120 (in effect 4). The main outcome measures are the current flow, distension media, tissue alteration, bleeding during resection, visibility and cost. Cutting power and coagulations appears sensibly better in comparison with monopolar resection, thanks to plasma effect. The vision during resection is not disturbed by the presence of the technical characteristics of the instruments. Results in terms of time of surgery, intra-operatory bleeding and complete removal of the pathology were better compared with traditional monopolar resection. There were no complications with bipolar resection thanks to use of saline solution as distention media. The bipolar resectoscope presents some advantages in comparison with the monopolar such as: better cut and coagulation by plasma effect of bipolar current, minor risks with the use of saline solution, lower alterations of the tissue, less bleeding during resection, better visibility and reduced cost.