A pilot study examining the frequency and quantity of gas embolization during operative hysteroscopy using a monopolar resectoscope

Joshua Bloomstone, Chi-Min Chow, Eric Isselbacher, Elizabeth VanCott, Keith B Isaacson
Journal of the American Association of Gynecologic Laparoscopists 2002, 9 (1): 9-14

STUDY OBJECTIVE: To assess baseline frequency of gas embolization during standard monopolar resectoscopic surgery.

DESIGN: Prospective, nonrandomized, observational study (Canadian Task Force classification II-2).

SETTING: Tertiary care medical center.

PATIENTS: Eleven women and three controls.

INTERVENTION: Operative hysteroscopy.

MEASUREMENTS AND MAIN RESULTS: Echocardiography and serum studies were performed to detect bubble formation in the inferior vena cava, hepatic veins, and right heart. Gas bubbles were present in the hepatic veins or right heart in 10 patients and no controls. No patients had changes in coagulation profile and only one had clinical changes during surgery.

CONCLUSION: Gas bubbles can been detected by echocardiography in most patients undergoing resectoscopic surgery in the uterus. Clinical significance may relate to anatomic variations as well as to gas bubble content and volume.

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