Objective:The aim of this research was to evaluate the efficiency of reciprocating morcellation for removing giant benign prostatic hyperplasia during holmium laser enucleation of the prostate,investigate whether perf...Objective:The aim of this research was to evaluate the efficiency of reciprocating morcellation for removing giant benign prostatic hyperplasia during holmium laser enucleation of the prostate,investigate whether performing morcellation as a two-stage procedure improves tissue retrieval efficiency,and seek to determine the optimal interval between the two surgeries.Methods:This study included nine cases of holmium laser enucleation of the prostate with an enucleated prostate weight exceeding 200 g,indicative of substantial prostate enlargement.Morcellation was performed on Day 0(n=4),Day 4(n=1),Day 6(n=1),and Day 7(n=3).The intervals were compared regarding the morcellation efficiency,beach ball presence,and pathology.Results:The mean estimated prostate volume was 383(range 330e528)mL;the median enucleation weight was 252(interquartile range[IQR]222,342)g;and the median enucleation time was 83(IQR 62,100)min.The mean morcellation efficiency was 1.44(SD 0.55)g/min on Day 0 and 13.69(SD 2.46)g/min on day 7.The morcellation efficiency was 4.15 g/min and 10.50 g/min on Day 4 and Day 6,respectively,with significantly higher in the two-stage group compared to one-stage group(11.0 g/min vs.1.5 g/min;p=0.014).Efficiency was strongly correlated with intervals(p<0.001);the incidences of beach balls were 100%(4/4)and 60%(3/5)in the immediate and two-stage surgery groups,respectively.Conclusion:The efficiency of two-stage morcellation with reciprocating morcellators was highly related to the postoperative interval,with the maximum efficiency reached on Day 7.展开更多
Objective: To reveal the breadth of experience for the intrauterine morcellator amongst gynecologists in a single US academic center. Design: Retrospective Descriptive. Setting: University Hospital. Patients: In total...Objective: To reveal the breadth of experience for the intrauterine morcellator amongst gynecologists in a single US academic center. Design: Retrospective Descriptive. Setting: University Hospital. Patients: In total, 33 hysteroscopic procedures, with intrauterine morcellation, were performed for 28 patients for benign endometrial disease at?Magee―Womens Hospital at the University of Pittsburgh Medical center between October 2006 and February 2012. Intervention: Operative Hysteroscopy with an intrauterine morcellator. Measurement and Main Results: The major indication for hysteroscopic surgery was endometrial polyp (54.5%), followed by intrauterine fibroids (18.2%), filling defect on sonohysterogram (15.2%), abnormal uterine bleeding (9.1%), and uterine synechiae (3%). The mean greatest diameter for all intrauterine pathology resected was 1.14 ± 0.46 cm (Range 0.6 - 1.9 cm), and, notably, the largest fibroid resected was 1.5 cm in greatest diameter. The average operative time was 39 ± 29 minutes (range 15 - 122 minutes), and average hysteroscopic fluid deficit was 286 ± 479.5 mL (range 30 - 2000 mL). There were only 2 patients for whom the deficit was greater than 1 L, one of whom underwent a myomectomy with total operative time of 26 minutes, while the other underwent a hysteroscopic adhesiolysis and had a total operative time of 122 minutes. The complication rate was 6.0%, and complications reported included uterine perforation (n = 1) and cervical injury (n = 1). Conclusion: The intrauterine morcellator is a useful tool for surgical treatment of intrauterine pathology that confers a low operative risk.展开更多
Hysteroscopic resection of endometrial lesions has recently gained popularities. We here report the usefulness and safety of hysteroscopic surgery using Intrauterine BIGATTI Shaver (IBS<span style="font-size:1...Hysteroscopic resection of endometrial lesions has recently gained popularities. We here report the usefulness and safety of hysteroscopic surgery using Intrauterine BIGATTI Shaver (IBS<span style="font-size:10.0pt;font-family:""><sup></span><span style="font-size:10.5pt;font-family:"color:#4F4F4F;background:white;">®</span><span style="font-size:10.0pt;font-family:""></sup></span><span>). We performed this surgery for 6 patients: 4 endometrial polyps and 2 intrauterine myoma. The average operation time was 25.7</span><span "=""> </span><span>±</span><span "=""> </span><span>13.2 minutes. Only a small amount of bleeding was noted in all cases. There were no surgical complications. Two out of four patients who desired childbearing became pregnant. Hysteroscopic surgery using IBS<span style="font-size:10.0pt;font-family:""><sup></span><span style="font-size:10.5pt;font-family:"color:#4F4F4F;background:white;">®</span><span style="font-size:10.0pt;font-family:""></sup></span></span><span> can safely and reliably remove intrauterine protruding lesions under aspiration without using a heat source. Less endometrial damage may help preserve fertility.</span>展开更多
文摘Objective:The aim of this research was to evaluate the efficiency of reciprocating morcellation for removing giant benign prostatic hyperplasia during holmium laser enucleation of the prostate,investigate whether performing morcellation as a two-stage procedure improves tissue retrieval efficiency,and seek to determine the optimal interval between the two surgeries.Methods:This study included nine cases of holmium laser enucleation of the prostate with an enucleated prostate weight exceeding 200 g,indicative of substantial prostate enlargement.Morcellation was performed on Day 0(n=4),Day 4(n=1),Day 6(n=1),and Day 7(n=3).The intervals were compared regarding the morcellation efficiency,beach ball presence,and pathology.Results:The mean estimated prostate volume was 383(range 330e528)mL;the median enucleation weight was 252(interquartile range[IQR]222,342)g;and the median enucleation time was 83(IQR 62,100)min.The mean morcellation efficiency was 1.44(SD 0.55)g/min on Day 0 and 13.69(SD 2.46)g/min on day 7.The morcellation efficiency was 4.15 g/min and 10.50 g/min on Day 4 and Day 6,respectively,with significantly higher in the two-stage group compared to one-stage group(11.0 g/min vs.1.5 g/min;p=0.014).Efficiency was strongly correlated with intervals(p<0.001);the incidences of beach balls were 100%(4/4)and 60%(3/5)in the immediate and two-stage surgery groups,respectively.Conclusion:The efficiency of two-stage morcellation with reciprocating morcellators was highly related to the postoperative interval,with the maximum efficiency reached on Day 7.
文摘Objective: To reveal the breadth of experience for the intrauterine morcellator amongst gynecologists in a single US academic center. Design: Retrospective Descriptive. Setting: University Hospital. Patients: In total, 33 hysteroscopic procedures, with intrauterine morcellation, were performed for 28 patients for benign endometrial disease at?Magee―Womens Hospital at the University of Pittsburgh Medical center between October 2006 and February 2012. Intervention: Operative Hysteroscopy with an intrauterine morcellator. Measurement and Main Results: The major indication for hysteroscopic surgery was endometrial polyp (54.5%), followed by intrauterine fibroids (18.2%), filling defect on sonohysterogram (15.2%), abnormal uterine bleeding (9.1%), and uterine synechiae (3%). The mean greatest diameter for all intrauterine pathology resected was 1.14 ± 0.46 cm (Range 0.6 - 1.9 cm), and, notably, the largest fibroid resected was 1.5 cm in greatest diameter. The average operative time was 39 ± 29 minutes (range 15 - 122 minutes), and average hysteroscopic fluid deficit was 286 ± 479.5 mL (range 30 - 2000 mL). There were only 2 patients for whom the deficit was greater than 1 L, one of whom underwent a myomectomy with total operative time of 26 minutes, while the other underwent a hysteroscopic adhesiolysis and had a total operative time of 122 minutes. The complication rate was 6.0%, and complications reported included uterine perforation (n = 1) and cervical injury (n = 1). Conclusion: The intrauterine morcellator is a useful tool for surgical treatment of intrauterine pathology that confers a low operative risk.
文摘Hysteroscopic resection of endometrial lesions has recently gained popularities. We here report the usefulness and safety of hysteroscopic surgery using Intrauterine BIGATTI Shaver (IBS<span style="font-size:10.0pt;font-family:""><sup></span><span style="font-size:10.5pt;font-family:"color:#4F4F4F;background:white;">®</span><span style="font-size:10.0pt;font-family:""></sup></span><span>). We performed this surgery for 6 patients: 4 endometrial polyps and 2 intrauterine myoma. The average operation time was 25.7</span><span "=""> </span><span>±</span><span "=""> </span><span>13.2 minutes. Only a small amount of bleeding was noted in all cases. There were no surgical complications. Two out of four patients who desired childbearing became pregnant. Hysteroscopic surgery using IBS<span style="font-size:10.0pt;font-family:""><sup></span><span style="font-size:10.5pt;font-family:"color:#4F4F4F;background:white;">®</span><span style="font-size:10.0pt;font-family:""></sup></span></span><span> can safely and reliably remove intrauterine protruding lesions under aspiration without using a heat source. Less endometrial damage may help preserve fertility.</span>
