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Advantages of CO2 in diagnostic hysteroscopy
August 2002, Vol. 9, No. 3 Supplement TheJournalof the American Association of Gynecologic Laparoscopists
147. Advantages of CO2 in Diagnostic Hysteroscopy 1H Reich, 2A Gallinat, 3TASeckin. 1Shavertown, Pennsylvania, 2Centre of Gynecological Endoscopy, Hamburg, Germany; 3New York, New York.
Measurements and Main Results. During tubal occlusion with the Essure System, use of medical resources, including time, materials, and personnel, was tracked. This information was supplemented by examination of billing and operative records. Compared with published cost analysis of laparoscopic tubal ligation, substantial reductions were seen in hospital facility costs ($574 and $125, respectively) and medicalsurgical supplies ($840 and $700, respectively). Additional savings were noted in staffing costs for the procedure room. Conclusion. Substantial cost savings seem to be associated with sterilization with the Essure System compared with laparoscopic tubal ligation.
Objective. To describe advantages of CO2 over lowviscosity fluids for uterine distention during diagnostic hysteroscopy. Measurements and Main Results. Diagnostic hysteroscopy was performed successfully with CO2 as the uterine distention medium. Conclusion. CO2 allows excellent visualization of the uterine cavity for diagnostic hysteroscopy.
148. Hysteroscopic Myomectomies Using CO2 for Uterine Distention 1H Reich, 2A Gallinat, 3TASeckin. 1Shavertown, Pennsylvania, 2Centre of Gynecological Endoscopy, Hamburg, Germany; 3New York, New York.
146. Does Menorrhagia Relief after Uterine Artery Embolization Depend on Uterine Size or Its Reduction? 1GE Pron, 2j Bennett, 3A Common, 1j Soucie, 4G Vilos. 1Department of Public Health Sciences, Toronto, Canada; 2Department Medical Imaging, London, Canada; 3Department Medical Imaging, Toronto, Canada; 4Department Obstetrics and Gynecology, University of Western Ohio, St. Joseph's Health Center, London, Canada.
Objective. To describe use of CO2 as uterine distention medium during operative hysteroscopy. Measurements and Main Results. Hysteroscopic intramural myomectomies were performed with CO2 as the uterine distention medium. All procedures were performed successfully with adequate visualization and without risks associated with fluid intravasation. Conclusion. CO2 uterine distention may be considered for operative hysteroscopy.
Objective. To evaluate the relationship between menorrhagia relief after uterine artery embolization (UAE) and initial size of the myomatous uterus and volume reduction. Measurements and Main Results. The 538 patients had ultrasound-documented myomas and symptoms including menorrhagia (17%) or menorrhagia with dysmenorrhea (63%). The primary embolic agent during UAE was polyvinyl alcohol (355-500 mm) and the technical end point was complete stasis in the uterine artery trunk. Three-month follow-up telephone interviews and ultrasound examinations were performed, with median uterine and myoma volume reductions of 35 % and 42%, respectively. Menorrhagia was significantly improved in 83% of women (95% CI 80-87). Improvements in menorrhagia were not related to initial uterine volume (p = 0.08) or postUAE volume reduction (p = 0.11). Similar levels of menstrual improvement were noted in patients with large uteri (>1000 cm3) having either low (<30%) or high (>50%) uterine volume reductions (73% vs 76%). Conclusion. Relief of menorrhagia after UAE is independent of initial myomatous uterus size and postUAE volume reduction.
149. A Totally New Approach to Electrosurgery V Remorgida. Dipartimento di Ginecologia ed Ostericia, Genoa, Italy. Objective. To present a new approach to electrosurgery allowing use of unipolar instruments in a bipolar fashion. Measurements and Main Results. A new electrosurgical unit (ESU; Karl Storz, Tuttlingen, Germany) allows closure of the electric circuit between two forceps; that is, the local area retum plate concept. The working area is the space between forceps; there is no lateral thermal spread beyond the retum plate. Limitations are two instruments in the field, and no more than 4 cm between active and passive elements. Three settings are available on the ESU: bipolar coagulation and cutting for a single instrument, separated bipolar coagulation and cutting for use of two bipolar instruments, and bipolar coagulation and unipolar cutting
$45
147. Advantages of CO2 in Diagnostic Hysteroscopy 1H Reich, 2A Gallinat, 3TASeckin. 1Shavertown, Pennsylvania, 2Centre of Gynecological Endoscopy, Hamburg, Germany; 3New York, New York.
Measurements and Main Results. During tubal occlusion with the Essure System, use of medical resources, including time, materials, and personnel, was tracked. This information was supplemented by examination of billing and operative records. Compared with published cost analysis of laparoscopic tubal ligation, substantial reductions were seen in hospital facility costs ($574 and $125, respectively) and medicalsurgical supplies ($840 and $700, respectively). Additional savings were noted in staffing costs for the procedure room. Conclusion. Substantial cost savings seem to be associated with sterilization with the Essure System compared with laparoscopic tubal ligation.
Objective. To describe advantages of CO2 over lowviscosity fluids for uterine distention during diagnostic hysteroscopy. Measurements and Main Results. Diagnostic hysteroscopy was performed successfully with CO2 as the uterine distention medium. Conclusion. CO2 allows excellent visualization of the uterine cavity for diagnostic hysteroscopy.
148. Hysteroscopic Myomectomies Using CO2 for Uterine Distention 1H Reich, 2A Gallinat, 3TASeckin. 1Shavertown, Pennsylvania, 2Centre of Gynecological Endoscopy, Hamburg, Germany; 3New York, New York.
146. Does Menorrhagia Relief after Uterine Artery Embolization Depend on Uterine Size or Its Reduction? 1GE Pron, 2j Bennett, 3A Common, 1j Soucie, 4G Vilos. 1Department of Public Health Sciences, Toronto, Canada; 2Department Medical Imaging, London, Canada; 3Department Medical Imaging, Toronto, Canada; 4Department Obstetrics and Gynecology, University of Western Ohio, St. Joseph's Health Center, London, Canada.
Objective. To describe use of CO2 as uterine distention medium during operative hysteroscopy. Measurements and Main Results. Hysteroscopic intramural myomectomies were performed with CO2 as the uterine distention medium. All procedures were performed successfully with adequate visualization and without risks associated with fluid intravasation. Conclusion. CO2 uterine distention may be considered for operative hysteroscopy.
Objective. To evaluate the relationship between menorrhagia relief after uterine artery embolization (UAE) and initial size of the myomatous uterus and volume reduction. Measurements and Main Results. The 538 patients had ultrasound-documented myomas and symptoms including menorrhagia (17%) or menorrhagia with dysmenorrhea (63%). The primary embolic agent during UAE was polyvinyl alcohol (355-500 mm) and the technical end point was complete stasis in the uterine artery trunk. Three-month follow-up telephone interviews and ultrasound examinations were performed, with median uterine and myoma volume reductions of 35 % and 42%, respectively. Menorrhagia was significantly improved in 83% of women (95% CI 80-87). Improvements in menorrhagia were not related to initial uterine volume (p = 0.08) or postUAE volume reduction (p = 0.11). Similar levels of menstrual improvement were noted in patients with large uteri (>1000 cm3) having either low (<30%) or high (>50%) uterine volume reductions (73% vs 76%). Conclusion. Relief of menorrhagia after UAE is independent of initial myomatous uterus size and postUAE volume reduction.
149. A Totally New Approach to Electrosurgery V Remorgida. Dipartimento di Ginecologia ed Ostericia, Genoa, Italy. Objective. To present a new approach to electrosurgery allowing use of unipolar instruments in a bipolar fashion. Measurements and Main Results. A new electrosurgical unit (ESU; Karl Storz, Tuttlingen, Germany) allows closure of the electric circuit between two forceps; that is, the local area retum plate concept. The working area is the space between forceps; there is no lateral thermal spread beyond the retum plate. Limitations are two instruments in the field, and no more than 4 cm between active and passive elements. Three settings are available on the ESU: bipolar coagulation and cutting for a single instrument, separated bipolar coagulation and cutting for use of two bipolar instruments, and bipolar coagulation and unipolar cutting
$45