Particulate matter generated during monopolar and bipolar hysteroscopic human uterine tissue vaporization.
OBJECTIVE
To characterize the insoluble particulate matter generated during hysteroscopic monopolar and bipolar electrosurgery.


METHODS
In vitro comparative study (Canadian Task Force Classification II-1).


METHODS
Teaching hospital.


METHODS
Eight patients undergoing hysterectomy with benign indications.


METHODS
Tissue blocks were divided, and 1g of tissue was vaporized using a monopolar and a bipolar vaporizing electrode.


RESULTS
The particles were examined at light microscopy to study their morphologic features. Particle analysis was carried out using a laser diffraction particle analyser. Monopolar uterine tissue vaporization generated particles of a smaller median diameter than did bipolar vaporization (0.13 microm and 0.25 microm, respectively). The distribution by particle surface area in both instruments seems to be complex, with peaks at 0.35 and 4.0 microm for monopolar-generated particles and 0.5 and 5.0 microm for bipolar-generated particles. Another smaller peak with larger particles produced by both instruments was identified at 30 microm. During monopolar uterine tissue vaporization, 9.96% of particles generated were smaller than 5 microm, whereas during bipolar vaporization, 3.81% of particles were smaller than 5 microm (p = .01).


CONCLUSIONS
Particulate matter generated during hysteroscopic electrosurgical vaporization using monopolar and bipolar instruments is heterodisperse and complex in shape. Monopolar vaporization results in particles of a smaller median diameter compared with bipolar vaporization. Both instruments generate 2 distinct populations of particles by surface area. The distribution of particles by volume during hysteroscopic electrosurgery is complex.
Farrugia
Martin
M
Queen Mary University of London, Barts & The London School of Medicine and Dentistry, Institute of Cell and Molecular Science, London, United Kingdom. martin@farrugia.demon.co.uk
Hussain
Sarah Y
SY
Perrett
David
D
D000328:Adult; D004598:Electrosurgery / Q000009:adverse effects* / Q000295:instrumentation*; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects*; D066298:In Vitro Techniques; D009215:Myometrium / Q000601:surgery*; D010316:Particle Size; D052638:Particulate Matter / Q000032:analysis*
D052638:Particulate Matter