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Re: endometial resection/ablationFrom: ENDODOK@aol.comFri Mar 24 17:18:19 2006
Endometrial resection entails using the resectoscope to remove about 3-4 mm of the entire endometrium. This will expose the underlying myometrium which is then (sealed) ablated with the rollerball. Would not recommend this procedure unless experienced in myoma resection. One can strip the endometrium in a few minutes. Also if patient c/o of dysmenorrhea, consider coincident adenomyosis. Resection may control her menorrhagia, but may worsen her dysmenorrhea. LSH may then be a better choice. Perforation and fluid overload rare complications if surgeon prudent and skillful. LSH a wonderful procedure but not without some risk.... ureter, bladder, and bowel injury. BTW, for LSH enthusiasts, if using Harmonic scalpel in conjunction with an uterine manipulator, do withdraw the manipulator before harmonic transection of the cx. If not either the scapel or the manipulator may fracture. Finding fractured pieces of plastic manipulator, or metal shards from the scapel can be very difficult. Glenn Bradley
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