Feasibility of a new two-step procedure for office hysteroscopic resection of submucous myomas: results of a pilot study

Haimovich, Sergio; Mancebo, Gemma; Alameda, Francesc; Agramunt, Sílvia; Solé-Sedeño, Josep M.; Hernández, José Luís; Carreras, Ramón

doi:10.1016/j.ejogrb.2013.01.002

Cited by 51 publications

(23 citation statements)

References 20 publications

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“…The main disadvantage for the clinical application of the diode laser might be its cost. Laser equipment currently tends to be expensive, which significantly reduces its widespread use [12,27]. Although the hysteroscopy findings at follow up and the obstetrical outcomes seem very promising, the current study was limited to a small number of patients.…”

Section: Commentmentioning

confidence: 99%

Hysteroscopic metroplasty for the septate uterus with diode laser: a pilot study

Nappi

Pontis²,

Sorrentino

et al. 2016

European Journal of Obstetrics & Gynecology and Reproductiv

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Section: Commentmentioning

confidence: 99%

Hysteroscopic metroplasty for the septate uterus with diode laser: a pilot study

Nappi

Pontis²,

Sorrentino

et al. 2016

European Journal of Obstetrics & Gynecology and Reproductiv

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“…The fibers are very fragile and expensive to replace. It can be used through small barrel scopes and can therefore be used without anesthesia or sedation [43].…”

Section: Surgical Aspects: Technique/equipmentmentioning

confidence: 99%

Belgian consensus on adhesion prevention in hysteroscopy and laparoscopy

Verguts

Bosteels

Roberta³

et al. 2015

Gynecol Surg

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Intrauterine and intraabdominal adhesions are a major cause for infertility. The most recent investigations have demonstrated the potential of intraperitoneal adhesion barriers combined with good surgical technique to reduce adhesion formation. For intrauterine adhesions we suggest to minimize unipolar and bipolar instrumentation whenever possible. We advocate the use of estrogens for 10 days after adhesiolysis: 2dd two tablets of estradiol 2 mg. Instillation of Hyalobarrier Gel Endo actually is not reimbursed but may have a beneficial effect after myomectomy or adhesiolysis. Concerning laparoscopic and laparotomic prevention of adhesion also, meticulous surgical technique is of the utmost importance. Residual blood should be avoided by careful hemostasis and rinsing with Ringer's lactate with heparin. Preferably braided sutures are not to be left in the abdominal cavity. We advise to avoid unipolar and bipolar cauterization when possible and to replace with ultrasonic or laser energy. The use of floatation barriers does not seem to add substantial benefit in the prevention of adhesions. Gel barriers (Hyalobarrier Gel Endo® or Intercoat®) are proven to have a significant effect on adhesion prevention. As for sheets, there is enough evidence that they prevent adhesions. The use of NSAID in the prevention of pain and/or corticosteroids in the prevention of postoperative nausea is already mainstay after surgery and can be further endorsed in the prevention of adhesions.

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“…Based on Bettocchi results we developed a new two-step technique for G2 and deep G1 fi broids, in which both steps were in offi ce setting without anesthesia [ 50 ]. The fi rst step was the same as Bettocchi´s technique, and second step for excision of the myoma was performed four weeks later using the same hysteroscope and setup (pressure, fl ow, suction) as those used for the fi rst offi ce procedure.…”

Section: Lasermentioning

confidence: 99%

“…The overlying endometrium could therefore be repaired without the formation of IUA at the site of resection. This also one of the reasons why a myomectomy technique has to respect the cleavage plane preserving the myometrium adjacent, like with the cold loop [ 54 ], or the two step enucleation with laser [ 50 ]. The method they recommend in order to prevent IUA is the use of an Intra Uterine Device (IUD), over the Foley Balloon due to an increase of infection risk with this method.…”

Section: Adhesionsmentioning

confidence: 99%