Fluid Uptake in Laser Endometrial Ablation

Abstract

Fluid uptake was measured from accurate preoperative and postoperative patient weights for 25 consecutive patients undergoing Nd:YAG laser endometrial ablation under general anaesthesia. One patient had a uterine perforation with 5.1 litres of fluid deposited in the peritoneal cavity. In the remaining 24 cases, maximum fluid uptake was 5.1 litres, three patients absorbed more than four litres and eight absorbed more than two litres. In those same 24 patients, the mean fluid uptake was 1.5 litres (SD 1.6) and six patients without tubal ligation had a higher mean uptake (2.2 litres, SD 1.7) than the eighteen with surgically occluded Fallopian tubes (1.3 litres, SD 1.4) but the difference was not statistically significant. Fluid uptake has the potential to cause significant morbidity in this procedure. Both procedure duration and volume of uterine irrigation fluid were poor predictors of fluid gain. Observation of the ongoing volume deficit between infused and collected fluid provided intraoperative monitoring of fluid gain that prevented complications from fluid overload in healthy patients. However, this method of monitoring fluid uptake may be insufficient to prevent either complications from glycine absorption, if glycine is used for irrigation, or fluid overload in patients with cardiac disease.