IBS? Integrated Bigatti Shaver versus conventional bipolar resectoscopy: a randomised comparative study |
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Authors: | G Bigatti C Ferrario M Rosales A Baglioni S Bianchi |
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Institution: | (1) U.O. di Ostetricia e Ginecologia, Ospedale Classificato San Giuseppe Via San Vittore, 12-20123 Milan, Italy;(2) Universit? degli Studi di Milano, Direttore dell’Unit? Opertiva di Ostetricia e Ginecologia Ospedale Classificato San Giuseppe Via San Vittore, 12-20123 Milan, Italy |
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Abstract: | Conventional bipolar resectoscopy is widely recognized as the first choice for major hysteroscopic operations. We recently
proposed an alternative approach to operative hysteroscopy called Integrated Bigatti Shaver (IBS?) that improves visualization
during the procedure, reducing several problems of conventional resectoscopy such as fluid overload, water intoxication, uterine
perforation and long surgeon’s learning curve. In cooperation with Karl Storz GmbH & Co., we created a new shaving system
that, when introduced through the straight operative channel of a panoramic 90° optic, allows performance of many major hysteroscopic
operations. The present randomised comparative study was designed to compare 50 cases performed with conventional bipolar
resectoscope with 50 cases performed with the IBS?. Several types of major intrauterine pathologies such as polyps and submucosal
myomas (according to ESGE classification) were included in the study. Two cases of via falsa were reported. In one case, the
procedure was immediately stopped with no further complication for the patient, whereas in the second patient, the complication
did not compromise the operative course. Dilatation time, overall procedure time, resection time and fluid balance were carefully
monitored during each procedure in the two groups. The aim of the study was to compare the two techniques to confirm several
advantages offered by the IBS? such as reduced dilatation of the cervix, better visualization during the procedure because
tissue chips are removed at the same time as the resection, no need for coagulation or cutting current, utilization of normal
saline and a much faster learning curve. |
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