Hysteroscopic myomectomy without anesthesia

Scarce literature about myoma removal without anesthesia has been published. The aim of this paper is to evaluate the feasibility of a new alternative for a hysteroscopic myomectomy in a conventional office setting, without need for anesthesia. Step-by-step description of the surgical technique has...

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Detalles Bibliográficos
Autores: Rodríguez-Mias, Nuria-Laia|||0000-0001-6670-4543, Cubo-Abert, Montserrat|||0000-0002-0315-1440, Gomila-Villalonga, Laura, Gómez-Cabeza, Juanjo, Poza-Barrasús, Jose Luis, Gil-Moreno, Antonio|||0000-0003-1106-5590
Tipo de recurso: artículo
Fecha de publicación:2019
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:226473
Acceso en línea:https://ddd.uab.cat/record/226473
https://dx.doi.org/urn:doi:10.5468/ogs.2019.62.3.183
Access Level:acceso abierto
Palabra clave:Morcellation
Endoscopy
Hysteroscopy
Uterine myomectomy
Leiomyoma
Descripción
Sumario:Scarce literature about myoma removal without anesthesia has been published. The aim of this paper is to evaluate the feasibility of a new alternative for a hysteroscopic myomectomy in a conventional office setting, without need for anesthesia. Step-by-step description of the surgical technique has been provided, based on video images. An office hysteroscopy was performed in a Gynecological Endoscopy Department of a tertiary European hospital. A 49-year-old woman was referred for management of severe hypermenorrhea. Consent and approval were received from the patient and the institutional review board, respectively. The introduction of a Truclear ® hysteroscopic polyp morcellator of 5.5 mm with optic of 0 degrees into the uterine cavity did not require any kind of anesthesia or cervical dilatation. The use of saline flow helped distend the cavity and identify a submucosal myoma. Under direct vision, a full myomectomy was performed via mechanical energy with continuous cutting movements, without any complication. After the procedure was completed, the excised material was aspirated through the device into a collecting pouch. A successful complete morcellation of a Type-0 submucosal leiomyoma with a polyp morcellator device was performed in an outpatient setting. Good medical results, good tolerance by the patient besides lower surgical risks due to mechanical instead of electrical energy are shown. In conclusion, this video demonstrates that a hysteroscopic myomectomy can be performed successfully in office with lower risk of complications from the procedure and without use of general anesthesia besides good tolerance by the patient.