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Journal of Minimally Invasive Gynecology, Vol 12, No 5, September/October Supplement 2005
patient is 50 years old and the indication of the operation is uterine myomatosis. Intervention: Laparoscopic supracervical hysterectomy with joining the rest of cervix, Lig. sacrouterinum both sides, part of peritoneum, and lig. rotundum both sides with ohne extracorporeal node. Measurements and Main Results: All patients were controlled on day 7th after operation. The long term control is still going on. Conclusion: Laparoscopic supracervical hysterectomy is an effective, low-morbidity operation for the patients with the prolapse prophylaxis with this method. THURSDAY, NOVEMBER 10, 2005 (4:39 PM– 4:45 PM) Open Communications 2—Education 62 Enhancing Pre-Operative Patient Understanding in Gynecological Laparoscopic Surgery Lenart MB, Fawcett S, Kingston A, Abbott JA, Vancaillie TG. Royal Hospital for Women Randwick, NSW, Australia Study Objective: To enhance patient understanding of pre, post-operative preparation for laparoscopic gynecological surgery. Design: Prospective pre-operative qualitative research questionnaire. Setting: Department of Endo-Gynaecology Royal Hospital for Women, Sydney. Patients: Patients presenting for elective gynecological surgery. Intervention: Questionnaire. Measurements and Main Results: A majority of women (56%) did not prefer in house education. Eighty-five percent preferred an information DVD as the most suitable mode of information delivery due to their ability to review it on multiple occasions. Conclusion: These data suggest that the current preparation of patients for theatre is inadequate. Written information seems to be misinterpreted and misunderstood. Patients prefer not to attend in house sessions for tour of facilities and explanations. An audio -visual information package may be a cost effective method for providing pre-operative information for patients attending for gynecological surgery.
THURSDAY, NOVEMBER 10, 2005 (4:45 PM– 4:51 PM) Open Communications 2—Education 63 Hysteroscopic Morcellation Versus Conventional Resectoscopy, a Randomized Controlled Trial Comparing Both Techniques in the Hands of Ob/Gyn Residents in Training Jansen FW, van Dongen H, Emanuel MH. Leiden University Medical Ctr, RC, Leiden, Netherlands; Leiden University Medical Ctr, RC Leiden, Netherlands; Spaarne Hospital, Haarlem, NH, Netherlands Study Objective: The purpose of this randomized controlled trial is to compare the learning curve of residents in training for both techniques. Intervention: 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 Results: 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. Conclusion: 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. THURSDAY, NOVEMBER 10, 2005 (4:51 PM– 4:57 PM) Open Communications 2—Education 64 Abnormal Uterine Bleeding and Quality of Life Measures after Microwave Endometrial Ablation Nieves A, Sobolewski C, Filip S, Lukes A. Duke University Medical Center, Durham, North Carolina Study Objective: To assess improvement in abnormal uterine bleeding and quality of life measures after microwave endometrial ablations performed at Duke University.
Journal of Minimally Invasive Gynecology, Vol 12, No 5, September/October Supplement 2005
patient is 50 years old and the indication of the operation is uterine myomatosis. Intervention: Laparoscopic supracervical hysterectomy with joining the rest of cervix, Lig. sacrouterinum both sides, part of peritoneum, and lig. rotundum both sides with ohne extracorporeal node. Measurements and Main Results: All patients were controlled on day 7th after operation. The long term control is still going on. Conclusion: Laparoscopic supracervical hysterectomy is an effective, low-morbidity operation for the patients with the prolapse prophylaxis with this method. THURSDAY, NOVEMBER 10, 2005 (4:39 PM– 4:45 PM) Open Communications 2—Education 62 Enhancing Pre-Operative Patient Understanding in Gynecological Laparoscopic Surgery Lenart MB, Fawcett S, Kingston A, Abbott JA, Vancaillie TG. Royal Hospital for Women Randwick, NSW, Australia Study Objective: To enhance patient understanding of pre, post-operative preparation for laparoscopic gynecological surgery. Design: Prospective pre-operative qualitative research questionnaire. Setting: Department of Endo-Gynaecology Royal Hospital for Women, Sydney. Patients: Patients presenting for elective gynecological surgery. Intervention: Questionnaire. Measurements and Main Results: A majority of women (56%) did not prefer in house education. Eighty-five percent preferred an information DVD as the most suitable mode of information delivery due to their ability to review it on multiple occasions. Conclusion: These data suggest that the current preparation of patients for theatre is inadequate. Written information seems to be misinterpreted and misunderstood. Patients prefer not to attend in house sessions for tour of facilities and explanations. An audio -visual information package may be a cost effective method for providing pre-operative information for patients attending for gynecological surgery.
THURSDAY, NOVEMBER 10, 2005 (4:45 PM– 4:51 PM) Open Communications 2—Education 63 Hysteroscopic Morcellation Versus Conventional Resectoscopy, a Randomized Controlled Trial Comparing Both Techniques in the Hands of Ob/Gyn Residents in Training Jansen FW, van Dongen H, Emanuel MH. Leiden University Medical Ctr, RC, Leiden, Netherlands; Leiden University Medical Ctr, RC Leiden, Netherlands; Spaarne Hospital, Haarlem, NH, Netherlands Study Objective: The purpose of this randomized controlled trial is to compare the learning curve of residents in training for both techniques. Intervention: 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 Results: 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. Conclusion: 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. THURSDAY, NOVEMBER 10, 2005 (4:51 PM– 4:57 PM) Open Communications 2—Education 64 Abnormal Uterine Bleeding and Quality of Life Measures after Microwave Endometrial Ablation Nieves A, Sobolewski C, Filip S, Lukes A. Duke University Medical Center, Durham, North Carolina Study Objective: To assess improvement in abnormal uterine bleeding and quality of life measures after microwave endometrial ablations performed at Duke University.