Background: Removal of endometrial polyps and submucosal fibroids by blind avulsion or excision with resectoscope is associated with risks such as fluid imbalance and uterine perforation. This review describes our cen...Background: Removal of endometrial polyps and submucosal fibroids by blind avulsion or excision with resectoscope is associated with risks such as fluid imbalance and uterine perforation. This review describes our centre’s experience with the intrauterine Bigatti shaver (IBS), a new method for resecting these lesions. Methods: All procedures performed between August 2015 and June 2016 were included. Patient demographics and operation details (set-up time, resection time, operative findings and complications) were collected at time of surgery using a standardised form. Results: 21 cases were performed between August 2015 and June 2016 by two senior gynaecologists. The majority (18, 86%) were performed for polyps associated with menstrual abnormalities or subfertility. Mean operating time was 9.6 minutes (range 3 - 25), median fluid input 1450 mls (range 700 - 3000) and median fluid deficit 100 mls (range 50 - 300). There were no cases of infection, perforation or fluid overload. The IBS blade was bent after resection of an anterior wall polyp in an anteverted uterus. A 3 mm grade 1 submucosal fibroid could not be resected as it was too hard in consistency. Conclusions: The constant clear visualisation provided by the continuous flow of fluid enabled fast and complete resection of sizeable polyps with minimal fluid deficit. No serious complications occurred despite this being the initial series performed by both surgeons. Bending of the blade may be avoided by rotating the camera such that the operating channel is situated just next to the lesion. A drainage sock was fashioned out of ribbon gauze and attached to the end of the suction tubing for collection of small polyp fragments. The IBS is a valuable addition to current methods for resection of endometrial polyps. Further study is required to determine its utility for submucosal fibroids, particularly those with a hard consistency.展开更多
Aim:The aim of this study was to evaluate the usefulness of suction-assisted cartilage shaver(SACS)system closed curettage by comparing it with open excision regarding safety and efficacy.Methods:A retrospective chart...Aim:The aim of this study was to evaluate the usefulness of suction-assisted cartilage shaver(SACS)system closed curettage by comparing it with open excision regarding safety and efficacy.Methods:A retrospective chart review was conducted for patients with axillary osmidrosis(AO)who underwent either open excision or SACS closed curettage between 2006 and 2018.We investigated the demographic data of patients and compared the postoperative complications and outcomes of the patients undergoing the two procedures.Results:A total of 91 patients underwent SACS closed curettage and 188 patients underwent open excision.The complication rate in the SACS group(10.4%)was significantly lower than that in the open excision group(20.7%).Each procedure led to unsuccessful outcomes for two patients.Conclusion:SACS closed curettage was safer than open excision for AO.Both procedures were extremely effective.Although decision-making for surgical treatment options for AO is affected by such other factors as discomfort in dressing,recovery time,scar formation,and cost,our results should be helpful for both surgeons and patients.展开更多
文摘Background: Removal of endometrial polyps and submucosal fibroids by blind avulsion or excision with resectoscope is associated with risks such as fluid imbalance and uterine perforation. This review describes our centre’s experience with the intrauterine Bigatti shaver (IBS), a new method for resecting these lesions. Methods: All procedures performed between August 2015 and June 2016 were included. Patient demographics and operation details (set-up time, resection time, operative findings and complications) were collected at time of surgery using a standardised form. Results: 21 cases were performed between August 2015 and June 2016 by two senior gynaecologists. The majority (18, 86%) were performed for polyps associated with menstrual abnormalities or subfertility. Mean operating time was 9.6 minutes (range 3 - 25), median fluid input 1450 mls (range 700 - 3000) and median fluid deficit 100 mls (range 50 - 300). There were no cases of infection, perforation or fluid overload. The IBS blade was bent after resection of an anterior wall polyp in an anteverted uterus. A 3 mm grade 1 submucosal fibroid could not be resected as it was too hard in consistency. Conclusions: The constant clear visualisation provided by the continuous flow of fluid enabled fast and complete resection of sizeable polyps with minimal fluid deficit. No serious complications occurred despite this being the initial series performed by both surgeons. Bending of the blade may be avoided by rotating the camera such that the operating channel is situated just next to the lesion. A drainage sock was fashioned out of ribbon gauze and attached to the end of the suction tubing for collection of small polyp fragments. The IBS is a valuable addition to current methods for resection of endometrial polyps. Further study is required to determine its utility for submucosal fibroids, particularly those with a hard consistency.
文摘Aim:The aim of this study was to evaluate the usefulness of suction-assisted cartilage shaver(SACS)system closed curettage by comparing it with open excision regarding safety and efficacy.Methods:A retrospective chart review was conducted for patients with axillary osmidrosis(AO)who underwent either open excision or SACS closed curettage between 2006 and 2018.We investigated the demographic data of patients and compared the postoperative complications and outcomes of the patients undergoing the two procedures.Results:A total of 91 patients underwent SACS closed curettage and 188 patients underwent open excision.The complication rate in the SACS group(10.4%)was significantly lower than that in the open excision group(20.7%).Each procedure led to unsuccessful outcomes for two patients.Conclusion:SACS closed curettage was safer than open excision for AO.Both procedures were extremely effective.Although decision-making for surgical treatment options for AO is affected by such other factors as discomfort in dressing,recovery time,scar formation,and cost,our results should be helpful for both surgeons and patients.
