Outpatient Hysteroscopic Polypectomy: Bipolar Energy System (Versapoint®) versus Mechanical Energy System (TRUCLEAR System®) - Preliminary Results.

HYPOTHESIS: The new hysteroscopic system with mechanical energy is an effective outpatient technique for diagnosis and treatment that has certain advantages over conventional hysteroscopy in the management of endometrial polyps. OBJECTIVES: Our primary objective was to assess the total duration of hysteroscopy and polypectomy performed in an outpatient setting comparing the new mechanical energy hysteroscopy to the bipolar energy system. Our secondary objective was to compare the level of safety of both hysteroscopic techniques using the procedure success rate, the need for subsequent referral to surgery, existing complications, and comfort experienced by the patient during the procedure. PATIENTS AND METHODS: This randomized controlled trial included the first 90 patients with an ultrasound diagnosis of endometrial polyp (>1 cm) who underwent an outpatient diagnostic and operative hysteroscopy at the Igualada Hospital (Barcelona) and agreed to be included in the study by signing an informed consent. RESULTS: We obtained a 91% success rate with the TRUCLEAR System® compared to a 69% success rate with the Versapoint® system. Total operating time was 6.36 min in the TRUCLEAR System group versus 10.82 min in the Versapoint system group (p < 0.05), with a polypectomy time of 3.06 and 7.91 min, respectively (p < 0.05). There were no significant differences between the two techniques when analyzing pain using the visual analogue scale. No complications were recorded for either technique. CONCLUSION: The mechanical energy system presents a significant decrease in the total duration of polypectomy and hysteroscopy when performed both by experienced staff and by staff in training, resulting in higher success rates without complications with respect to conventional hysteroscopy with bipolar energy.

Use of mobile phones as a tool for weight loss: a systematic review.

We conducted a systematic review of the literature on the use of mobile phones for weight loss. A total of 43 studies were identified on obese or overweight adults, aged 18 years or over. After review, ten articles met the inclusion criteria. There were 19-534 participants per study. Participants were from European, Asian and North American regions. The mean body mass index (BMI) of the subjects varied from 22 to 36 kg/m(2). Two studies used text messaging or multimedia messaging. All the other studies used mobile-phone apps or web-based programmes that could be accessed from mobile phones as a part of a weight-loss intervention or for evaluating their potential for use and their acceptance. Most studies lasted 2-4 months and the maximum duration was 1 year. All but two studies showed reductions in the participants' bodyweight, BMI, waist circumference and body fat in the various interventions. There appeared to be a proportional relationship between weight loss and programme use. The programmes most benefited those who took a pro-active approach to everyday problems. Frequent self-recording of weight seemed to be important, as was the personalisation of the intervention (counselling and individualized feedback). Finally, a social support system acted as a motivational tool.

Estudio descriptivo del nuevo sistema morcelador de histeroscopia diagnóstica-terapéutica / Descriptive study of a new diagnostic-therapeutic hysteroscopic morcellation system

Hipótesis. El nuevo sistema de morcelación es una técnica histeroscópica diagnóstica-terapéutica eficaz y segura para el tratamiento ambulatorio de pólipos endometriales. Objetivo. Describir nuestra experiencia inicial con el nuevo sistema de morcelación histeroscópica Truclear System (Smith & Nephew) en término de polipectomías realizadas a nivel ambulatorio sin necesidad de derivación quirúrgica de la paciente. Pacientes y métodos. Estudio observacional prospectivo no aleatorizado que incluye las 100 primeras pacientes en las que se les realizó una histeroscopia con el nuevo sistema morcelador entre junio del 2011 a enero del 2012 en el Hospital de Igualada. Se diferencian 2 grupos de pacientes. Grupo 1: 55 primeras pacientes que cumplen alguno de los criterios de inclusión establecidos para la realización de una histeroscopia; Grupo 2: 45 pacientes con sospecha diagnóstica-ecográfica de pólipo endometrial. Resultados. Se realizó un total de 41 y 40 histeroscopias en el grupo 1 y 2 respectivamente, obteniendo una sospecha histeroscópica de pólipo endometrial en el 56 y 82,5% respectivamente. La tasa de éxito en la polipetomía fue del 100%, sin necesidad de derivación quirúrgica posterior en ningún caso y con una tolerancia buena o regular en el 91,3% de las pacientes. Conclusión. El nuevo sistema morcelador permite la realización de la polipectomía a nivel ambulatorio sin necesidad de derivación quirúrgica en aquellas pacientes con diagnóstico ecográfico de pólipo (AU)

Hypothesis: The new morcellation system is a safe and effective diagnostic-therapeutic technique for the outpatient management of endometrial polyps. Objective: To describe our inicial experience with the new mechanical Truclear System (Smith&Nephew) hysteroscope in a number of polypectomies performed in the outpatient setting without the need for surgical referral. Patients and methods: An observational prospective non-randomized study was performed in 100 patients who underwent hysteroscopy between June 2011 and January 2012 at the Igualada Hospital. There were two patient groups: group 1 included the first 55 patients who met the inclusion criteria for hysteroscopy and group 2 included 45 patients with endometrial polyps suspected on ultrasound. Results: We performed 41 and 40 uneventful hysteroscopies in groups 1 and 2, respectively, 56 and 82.5% were suspected endometrial polyps, respectively. Polypectomy was 100% successful in all patients. None of the patients were referred for surgery. Tolerance was moderate to good in 91.3% of the patients. Conclusion: The new morcellator system allows polypectomies to be conducted in outpatients with an ultrasound diagnosis of polyps, without the need to refer the patient for surgery (AU)