4 Endometrial resection

E. M. Holt, M. D. G. Gillmer
In: Baillière's Clinical Obstetrics and Gynaecology · 1995 · vol. 9(2) , pp. 279–297 · doi:10.1016/s0950-3552(05)80039-2 · PMID:7554613 · W1973411537
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This paper describes the technique and outcomes of endometrial resection for treating abnormal uterine bleeding and other gynecological conditions.

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Abstract

The development of hysteroscopy and endometrial resection is reviewed and instrumentation is described. Suitable fluids for uterine distension and methods of delivery are discussed and safe limits to fluid absorption suggested. Selection of patients, preoperative investigation and preparation are described. Anaesthesia and operative technique are discussed with particular reference to the methods used by the authors and some common operative problems and their solutions are described. The results of treatment are discussed with reference to the published literature and two additional large unpublished series; one of 500 resections carried out in Oxford by 19 surgeons, of widely differing experience, with a follow-up period from 1 to 5 years; the other a personal series of 585 cases done by one of the authors (E.M.H.) with a follow-up period of 1 to 4 years. Factors affecting the likely success of the procedure, operative and post-operative complications, the difficulty and results of repeated resections and the indications for subsequent hysterectomy are discussed. Finally, the economic aspects of the technique and the author's conclusions as to the place of endometrial resection in the treatment of menorrhagia are given.

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