ABSTRACT
A randomized, case control, prospective trial was performed to determine whether radial expanding cannulas offer advantages over conventional disposable cannulas. Laparoscopy was performed in 20 women using one or the other of these instruments. Pain was evaluated immediately postoperatively, and at 24 and 96 hours with a visual analog scale. No difference between techniques was noted at the immediate postoperative analysis. Pain scores were significantly reduced with the radial expanding cannula at 24 hours (p <0.0005) and 96 hours (p <0.04). Cannula slippage was significantly reduced with the radial expanding cannula compared with the conventional disposable cannula (p <0.02). Three cases of cannula-related bleeding occurred with conventional device, and one with the radial expanding device. The radial expanding cannula results in less long-term pain and less slippage than conventional disposable cannulas.
ABSTRACT
We assessed the safety of a new method of endometrial ablation using heated saline in 11 patients who were undergoing elective hysterectomy. The EnAbl system consists of a controller, computer, and disposable, flexible probe that provides in situ heating and circulation of the saline while maintaining a tight seal at the internal os. The system's low pressure precluded ligation of the oviducts. Temperatures of the saline, uterine serosa, subserosa, and oviducts were monitored throughout the 15-minute procedure in all 10 treatments and 1 control. Histology revealed an average depth of treatment of 4 mm, including necrosis of the surface myometrium. Average depth of necrosis was consistent throughout the cavity regardless of the presence of insignificant myomas. Serosal, subserosal, and oviduct temperatures remained low (<e;45° C) during the 10 treatments of 70 to 85° C. We believe that this method provides an efficacious depth of treatment while maintaining safe serosal temperatures.
