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Re: Cervical stenosis was:acutely anteflexed uterusFrom: Gerald P.Rodriguez (geraldpr@cybermesa.com)Sun Jul 22 17:37:40 2007
I always insisted on having a tear duct probe available as my first dilator in an instance as you describe--severe stenosis as is fairly common in postmenopausal patients. Gerald P. Rodríguez, M.D., FACOG Santa Fe
> ----- Original Message ----- In a message dated 7/22/2007 4:09:37 P.M. Eastern Daylight Time, dahmd@cfl.rr.com writes: Nice job, Joanne. I have not used a flexible scope for the Essure procedure. Along the same lines as Joanne's story, I would like to share with the group a "technique" I tried for the first time the other day out of desperation. The patient is postmenopausal and had a failed attempt at office hysteroscopy with endometrial sampling due to the worst stenosis I have ever seen. Her internal os was about as big as the tip of a ballpoint pen, so I did it in the OR. Even the half-step dilators were too big to pass. Fearing a perforation, I placed the smallest half-step dilator up to the pinpoint opening, then slid the smallest 30-degree diagnostic hysteroscope I could find over the top of the dilator. I was able to watch the dilator go into the opening, and was able to control the depth of penetration so that it was only a few mm with each pass. I did this sequentially until I could pass the laparoscope. No perf. I'm sure others here have used this before, but perhaps someone can benefit from my initial frustration. Have a nice weekend. Ashley Nice job Ashley. I have used lacrimal duct probes with success in this situation. We only have 5mm diagnostic scopes. Robert Modugno MD MBA FACOG Sylva, NC ------------------------------------------------------------------------------ ------------------------------------------------------------------------- Get a sneak peek of the all-new AOL.com. -- -------------------------------------------------------------------------
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