Search

Background: Hysteroscopy requires accurate collection of unabsorbed distension media to measure patient fluid absorption. We assessed the effectiveness and usability of a novel total capture drape compared with a standard drape during hysteroscopy., Method: Simulation trials were followed by an early-phase study to compare fluid-capture efficiency and measures of drape usability during hysteroscopy randomizing the total capture drape compared with a standard drape., Experience: Simulation trials indicated complete collection of unabsorbed fluid with the total capture drape and progressive loss of unabsorbed fluid with the standard drape. An early-phase study with 68 women found no statistical difference between groups for the hysteroscopic fluid deficit, but saw fewer cases with lost fluid in the total capture drape compared with the standard drape. Direct observation and focus group data indicated a trend for better capture of unabsorbed fluid with the total capture drape, along with increased usability once surgeons became familiar with correct placement., Conclusion: Simulation and early-phase study results are favorable for the total capture drape, demonstrating comparable fluid collection with the standard drape. With repeated use and in-service training, surgeons expressed greater confidence in the accuracy of the hysteroscopic fluid deficit with the total capture drape compared with the standard drape. Design modifications should improve overall usability and fluid-capture efficiency., Competing Interests: Financial Disclosure Paul B. Marshburn, M.D. disclosed being the inventor of U.S. patent No. 10,182,877 granted on January 22, 2019, covering the Total Capture Drape design and use. He reported no funding or financial gain from the patented drape. Paul B. Marshburn disclosed a payment for consulting from Cardinal Health. Brittany L. Anderson-Montoya disclosed receiving funding from the Society for Simulation in Healthcare for Associate Editor duties for the Journal and Mission Health for a guest speaker lecture. Leslie Hansen-Lindner reports receiving funding for expert testimony. The other authors did not report any potential conflicts of interest., (Copyright © 2021 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Objective: Although laparoscopy is an important tool for evaluating pelvic pathology, visualization is limited to the surface of structures. A method of seeing below the surface during laparoscopy could be useful. We report on our early experience with new laparoscopic ultrasound., Study Design: Following diagnostic laparoscopy the pelvis is filled with fluid to obtain optimal imaging. A 10-mm ultrasound probe is introduced through the umbilical trocar and the uterus and adnexa examined., Results: High-resolution images can be obtained to delineate such abnormalities as suspected ovarian cysts and uterine myomata., Conclusion: Endoscopic ultrasound is a new instrument that allows the surgeon to evaluate and define pelvic pathology suspected at the time of laparoscopy. Endoscopic ultrasound may augment the diagnosis of subtle pathologic findings during laparoscopy.

The article offers information on a study related to office hysteroscopy. Topics discussed include the rates of infection and post-hysteroscopy pain reported in this study reflect what occurs in the general population after office hysteroscopy; and mentions hysteroscopy without a speculum may be less catchy but is a more accurate description.