Hysteroscopic myomectomy without anesthesia
Rodríguez-Mias, Nuria-Laia (Hospital Universitari Vall d'Hebron)
Cubo-Abert, Montserrat (Hospital Universitari Vall d'Hebron)
Gomila-Villalonga, Laura (Hospital Universitari Vall d'Hebron)
Gómez-Cabeza, Juanjo (Hospital Universitari Vall d'Hebron)
Poza-Barrasús, Jose Luis (Hospital Universitari Vall d'Hebron)
Gil-Moreno, Antonio 1965- (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Fecha:	2019
Resumen:	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.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Morcellation ; Endoscopy ; Hysteroscopy ; Uterine myomectomy ; Leiomyoma
Publicado en:	Obstetrics & Gynecology Science, Vol. 62 (april 2019) , p. 183-185, ISSN 2287-8580

DOI: 10.5468/ogs.2019.62.3.183
PMID: 31139595

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