Hysteroscopic morcellator for removal of intrauterine polyps and myomas: a randomized controlled pilot study among residents in training.
The purpose of this randomized controlled study was to compare conventional resectoscopy and hysteroscopic morcellation among residents in training (Canadian Task Force classification I). Sixty women with an intrauterine polyp or myoma were randomized to either hysteroscopic removal by conventional resectoscopy or hysteroscopic morcellation performed by 6 residents in training for obstetrics and gynecology (10 procedures per resident). The mean operating time for resectosocpy and morcellation was 17.0 (95% confidence interval [95% CI] 14.1-17.9, standard deviation [SD] 8.4) and 10.6 (95% CI 7.3-14.0, SD 9.5) min, respectively (p = .008). Multiple linear regression analysis showed that operating time increased significantly, for both resectoscopy and morcellator, when volume of intrauterine disorder increased. The use of the hysteroscopic morcellator reduced operating time more than 8 min in comparison to conventional resectoscopy (p < .001) when correction for volume was applied. Subjective surgeon and trainer scores for convenience of technique on a visual analog scale were in favor of the morcellator. No learning curve was observed. In conclusion, the hysteroscopic morcellator for removal of intrauterine polyps and myomas offers a good alternative to conventional resectoscopy for residents in training.
van Dongen
Heleen
H
Department of Gynaecology, Leiden University Medical Center, Leiden, The Netherlands. H.van_Dongen@lumc.nl
Emanuel
Mark Hans
MH
Wolterbeek
Ron
R
Trimbos
J Baptist
JB
Jansen
Frank Willem
FW
D000328:Adult; D002983:Clinical Competence; D004564:Electrocoagulation / Q000295:instrumentation; D005260:Female; D006176:Gynecology / Q000193:education*; D006801:Humans; D015907:Hysteroscopy; D007396:Internship and Residency; D007889:Leiomyoma / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010865:Pilot Projects; D011127:Polyps / Q000601:surgery*; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery*