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miller headshot 2012

MASTER CLASS IN MIGS: Hysteroscopic Morcellation

The Ob. Gyn News’ Master Class in Gynecologic Surgery is hosted by AAGL SurgeryU, and is edited by Dr. Charles E. Miller, a past president of the AAGL, and a long standing faculty member of SurgeryU. This month’s edition of the Master Class covers strategies for performing hysteroscopic morcellation of the uterus.

 

HYSTEROSCOPIC MORCELLATION 

By Dr. Joseph Sanfillipo

When an endometrial polyp or a submucous myoma (type 0, by the European Society of Gynecological Endoscopy classification) is identified, options for hysteroscopic removal should be considered, especially in the infertile patient. The more advanced approach utilizes hysteroscopic morcellation. Complete containment and evacuation of intrauterine pathology can be obtained with the hysteroscopic morcellation systems Myosure (Hologic, Bedford, MA) and TRUCLEAR (Smith & Nephew, Andover, MA). Fluid management systems have expanded the ability to obtain adequate uterine cavity distension and fluid absorption monitoring. Unlike laparoscopic power morcellation, there are few if any concerns about spreading or upstaging an unsuspected leiomyosarcoma. Polypectomy is best approached from the distal end of the polyp proximally to the uterine endometrial wall.Resection times are relatively short, < 10min. on average, with modest fluid retention if at all. This video demonstrates hysteroscopic morcellation of an intrauterine polyp.

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Filed under "Master Course in Gynecologic Surgery".

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