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Cavaterm endometrial ablation
August 1999, Vd. 6, No. 3 Supplement The Journal of the American Association of Gynecologic Laparoscopists
57. Laparoscopic Myomectomy / Ferrari, L Minelli, R Zaccoletti. S. Cuore Hospital of Negrar, Verona, Italy.
Measurements and Main Results. Hysteroscopic transcervical endometrial resection was performed in 26 women under general anesthesia during acute uterine bleeding. A benign organic cause was present in 25 women. Carcinoma was detected in endometrial chips in a postmenopausal woman and was treated by hysterectomy. Fifteen cycling women experienced complete remission of uterine bleeding, and one underwent hysterectomy during follow-up. Atrophic endometrium was present in nine menopausal women during follow-up. Conclusion. Endometrial transcervical resection was effective in controlling heavy bleeding, preventing future episodes of severe bleeding, and avoiding further medical or surgical treatment during 14 mouths of follow-up.
Objective. To evaluate intraoperative and postoperative outcomes of 256 laparoscopic myomectomies. Measurements andMain Results. Atotal of 198 patients (mean age 37.2 _+ 5.8 yrs) underwent total laparoscopic myomectomy. Indications were symptomatic pelvic mass (55%), bleeding not responding to medical treatment (18%), chronic pelvic pain (20%), and infertility (6.6%). Most myomas (201, 78.5%) were more than 40 mm and 53.9% were interstitial. Median operating time was 96.2 minutes, and blood loss was greater than 300 ml in nine patients; five women (2.5%) required conversion to laparotomy. One woman (0.5%) required second-look laparoscopy for hemoperitoneum. No patients had a nonautologous blood transfusion. The mean decrease of hemoglobin was 1.48 __.0.9 g/dl. Four women (2%) developed postoperative fever (<39 ~ C). Conclusion. Our experience shows that laparoscopic myomectomy is a safe technique.
60. Cavaterm Endometrial Ablation 13Friberg. Lund University Hospital, Lund, Sweden.
Objective. To assess the safety and the efficacy of endometrial destruction by thermal coagulation as an alternative to hysterectomy. Measurements and Main Results. More than 200 women underwent outpatient endometrial ablation with the Cavaterm on random cycle days and with no pretreatment with GnRH analogs. Treatments were done under paracervical block. All began with D&C to thin endometrium and obtain specimens for histopathologic diagnosis. Duration of treatment was 15 minutes. Five years after the first procedure the success rate is 94% when intracavitary changes and submucosal leiomyomas seen at pretreatment transvaginal sonography are excluded. Excellent satisfaction with treatment was reported by 91% of women, and another 6% reported good satisfaction. Conclusion. The Cavaterm system is an effective treatment for menorrhagia, being safe for patients and easy to learn for physicians.
58. Long-Term Outcomes of a 3-D Bipolar Endometrial Ablation System 1CA Fortin, 1T Fulop, 2JG Garza-Leal. 1La Salle Hospital, Chateauguqy, Quebec, Canada; 2University Hospital, Monterrey, N.L. Mexico.
Objective. To report on long-term clinical efficacy of 3-D bipolar global ablation (NovaSure). Measurements and Main Results. Of 40 premenopausal women with menorrhagia but no uterine pathology, 21 received pretreatment with GnRH agonists and 19 received no pretreatment. NovaSure ablation was successful and without adverse events. Mean procedure time was 64 seconds. One patient became menopausal and was excluded from the study results. The amenorrhea rate at 12 months exceeded 80%, with overall success rate greater than 95%. Conclusion. This new technology is potentially a rapid and effective treatment for women with menorrhagia.
61. Prospective Investigation on the Effect of Laparoscopic Electrothermal Treatment of Endopelvic Fascia for Women with GUSI DI Galen. Reproductive Science Center of the San Francisco Bay Area, San Ramon, California.
59. Emergency Endometrial Resection in Women with Acute Severe Uterine Bleeding M Franchini, A Nardi, L Cianferoni, A Scuderi. SM Annunziata Hospital, Florence, Italy.
Objective. To evaluate the safety and efficacy of laparoscopic electrothermal shrinkage of endopelvic fascia in treatment of GUSI due to urethral hypermobility. Measurements and Main Results. Ten women (age 39-63 yrs) with no prior abdominal surgery and with
Objective. To evaluate the efficacy and safety of endometrial hysteroscopic resection in women with acute severe uterine bleeding. S17
57. Laparoscopic Myomectomy / Ferrari, L Minelli, R Zaccoletti. S. Cuore Hospital of Negrar, Verona, Italy.
Measurements and Main Results. Hysteroscopic transcervical endometrial resection was performed in 26 women under general anesthesia during acute uterine bleeding. A benign organic cause was present in 25 women. Carcinoma was detected in endometrial chips in a postmenopausal woman and was treated by hysterectomy. Fifteen cycling women experienced complete remission of uterine bleeding, and one underwent hysterectomy during follow-up. Atrophic endometrium was present in nine menopausal women during follow-up. Conclusion. Endometrial transcervical resection was effective in controlling heavy bleeding, preventing future episodes of severe bleeding, and avoiding further medical or surgical treatment during 14 mouths of follow-up.
Objective. To evaluate intraoperative and postoperative outcomes of 256 laparoscopic myomectomies. Measurements andMain Results. Atotal of 198 patients (mean age 37.2 _+ 5.8 yrs) underwent total laparoscopic myomectomy. Indications were symptomatic pelvic mass (55%), bleeding not responding to medical treatment (18%), chronic pelvic pain (20%), and infertility (6.6%). Most myomas (201, 78.5%) were more than 40 mm and 53.9% were interstitial. Median operating time was 96.2 minutes, and blood loss was greater than 300 ml in nine patients; five women (2.5%) required conversion to laparotomy. One woman (0.5%) required second-look laparoscopy for hemoperitoneum. No patients had a nonautologous blood transfusion. The mean decrease of hemoglobin was 1.48 __.0.9 g/dl. Four women (2%) developed postoperative fever (<39 ~ C). Conclusion. Our experience shows that laparoscopic myomectomy is a safe technique.
60. Cavaterm Endometrial Ablation 13Friberg. Lund University Hospital, Lund, Sweden.
Objective. To assess the safety and the efficacy of endometrial destruction by thermal coagulation as an alternative to hysterectomy. Measurements and Main Results. More than 200 women underwent outpatient endometrial ablation with the Cavaterm on random cycle days and with no pretreatment with GnRH analogs. Treatments were done under paracervical block. All began with D&C to thin endometrium and obtain specimens for histopathologic diagnosis. Duration of treatment was 15 minutes. Five years after the first procedure the success rate is 94% when intracavitary changes and submucosal leiomyomas seen at pretreatment transvaginal sonography are excluded. Excellent satisfaction with treatment was reported by 91% of women, and another 6% reported good satisfaction. Conclusion. The Cavaterm system is an effective treatment for menorrhagia, being safe for patients and easy to learn for physicians.
58. Long-Term Outcomes of a 3-D Bipolar Endometrial Ablation System 1CA Fortin, 1T Fulop, 2JG Garza-Leal. 1La Salle Hospital, Chateauguqy, Quebec, Canada; 2University Hospital, Monterrey, N.L. Mexico.
Objective. To report on long-term clinical efficacy of 3-D bipolar global ablation (NovaSure). Measurements and Main Results. Of 40 premenopausal women with menorrhagia but no uterine pathology, 21 received pretreatment with GnRH agonists and 19 received no pretreatment. NovaSure ablation was successful and without adverse events. Mean procedure time was 64 seconds. One patient became menopausal and was excluded from the study results. The amenorrhea rate at 12 months exceeded 80%, with overall success rate greater than 95%. Conclusion. This new technology is potentially a rapid and effective treatment for women with menorrhagia.
61. Prospective Investigation on the Effect of Laparoscopic Electrothermal Treatment of Endopelvic Fascia for Women with GUSI DI Galen. Reproductive Science Center of the San Francisco Bay Area, San Ramon, California.
59. Emergency Endometrial Resection in Women with Acute Severe Uterine Bleeding M Franchini, A Nardi, L Cianferoni, A Scuderi. SM Annunziata Hospital, Florence, Italy.
Objective. To evaluate the safety and efficacy of laparoscopic electrothermal shrinkage of endopelvic fascia in treatment of GUSI due to urethral hypermobility. Measurements and Main Results. Ten women (age 39-63 yrs) with no prior abdominal surgery and with
Objective. To evaluate the efficacy and safety of endometrial hysteroscopic resection in women with acute severe uterine bleeding. S17