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Monday, 26 June, 2000, 09:27 GMT 10:27 UK
Surgery technique could save wombs
Surgery
Technique coud replace traditional surgery
A new method of keyhole surgery could mean fewer hysterectomies are needed - as well as reducing danger and discomfort.

And the technique could also make it easier for doctors to confirm suspected cancer and start treatment earlier.

Doctors often need to remove growths such as polyps and fibroids from the inside of the womb.



The number of patients who will benefit from the advantages of minimal access surgery instead of undergoing unnecessary hysterectomies should also increase

Dr Mark Emanuel, uterine shaver inventor

The "uterine shaver" does this just like a safety razor - using an angled blade set within an endoscope probe.

Although this sounds painful, it is a lot simpler than the current method, called resectoscopy, which again uses the probe, but instead has a wire loop and electric current to literally burn off the tissue.

This technique has a number of potentially hazardous side effects, either from excess burns, or from other liquids used to aid the technique.

These can enter blood vessels, upset the body's chemical balance, and in extreme cases cause brain or lung problems, heart failure, and even death.

The new technique was developed at Spaarne Hospital in the Netherlands, and 15 patients with endometrial polyps or small superficial fibroids have received the treatment.

Another, more extensive trial involving 100 patients is planned, and it is hoped that it could be more widely available within the next couple of years.

Simplicity is key

A key advantage of the technique is its simplicity - resectoscopy is carried out under general anaesthetic, and requires a stay in hospital, while the "intrauterine shaving" could theoretically be carried out under local anaesthetic as an outpatient.

In addition, the sample of tissue removed can be kept and sent for analysis, unlike resectoscopy, which destroys the tissue involved.

Dr Mark Emanuel, who developed the device, said: "The most important aspect of the new method is its simplicity.

"Resectoscopy is effective but involves a large number of steps, is tiring, difficult to learn and to become expert at.

"The shaver's safety and easiness of use will, hopefully, increase the number of gynaecologists who will use hysterscopic methods.

"This means that the number of patients who will benefit from the advantages of minimal access surgery instead of undergoing unnecessary hysterectomies should also increase."

The average operating time under the new method was halved, said Dr Emanuel.

However, he said it was as yet uncertain whether the technique could cause excessive bleeding in some cases.

He said: "We have not yet encountered any cases in the small number of patients on which we have used this."

He also warned that it could prove more expensive to buy and use the equipment.

Around 10% of women have menstrual disorders - approximately a third of these will have growths such as polyps and fibroids.

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24 Nov 99 | Health
Hysterectomy 'may improve sex'
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