The techniques for using the resectoscope and hysteroscopic morcellators will be discussed under hysteroscopic myomectomy.
- The electrode should only be activated as it is being moved into the resectoscope sheath, that is, towards the cervix.
- Depending on which electrode is chosen, the operator can cut, coagulate or vaporise by adjusting the setting on the generator.
- The myometrium should not be cut too deeply, particularly at the cornu and in the cervix.
- The uterine distension medium used at operative hysteroscopy differs according to the energy used. Most units now use bipolar energy therefore N/saline is used as a distension medium. If monopolar energy is used, an electrolyte-free medium e.g. glycine 1.5% is used.
- Fluid balance should be monitored closely throughout. If N/Saline is used as the distension medium the procedure must be stoppd when a fluid deficit of 2500 ml is reached. If 1.5% glycine is used the procedure must be stopped at a deficit of 1000 ml.
Versapoint® bipolar electrosurgery system
- Operates in normal saline distension media.
- 5 fr. electrodes (ball, twizzle and spring) deliver bipolar energy through 5 fr. instrument channels to vaporise, cut and desiccate tissue.
- Suitable for polypectomy, myomectomy (small, submucous part only), adhesiolysis and metroplasty.
- A Versapoint® resectoscope that uses saline solution for transcervical resection of the endometrium is available.