General Session V – Telesurgery Session: The Cold Loop Hysteroscopic Myomectomy

Date


Day 5: Thursday, November 15, 2018


Time


3:25 pm – 5:05 pm


Location


Room: Premier Ballroom


Chair


Marie Fidela R. Paraiso, Cleveland, Ohio


Surgeon


Ivan Mazzon – Rome, Italy


Moderators


Miguel A. Bigozzi, Buenos Aires, Argentina


Faculty


Resad P. Pasic Liselotte Mettler, Harry Reich, Joseph S. Sanfilippo

Description


This case provides a live surgical demonstration of the Cold Loop Hysteroscopic Myomectomy (CLHM). This technique was conceived in 1995 and allows you to overcome the limits represented by the classical slicing technique. This helps ensures a safe and effective myometrial sparing treatment of the submucous myomas. With the CLHM, the electrical force is replaced by the mechanical one during the liberation of the intramural part of the fibroid. The fibroconnectival bridges that anchor the fibroid to its pseudocapsule are mechanically disconnected by the cold loops, releasing the fibroid from the myometrium, without any consequence to surrounding healthy muscular fibers. The myometrium contractions to support the sliding of the intramural component of myoma into the uterine cavity, becoming an intracavitary pathology which is much easier to treat. This case demonstrates the technique of CLHM, discusses setting and instrumentation needed for this procedure, and will show tips and tricks to apply this technique avoiding intraopera-tive complications


Learning Objectives


At the conclusion of this activity, the participant will be able to: 1) Explore the use of cold loop for hysteroscopic myomectomy for submucous fibroids; 2) demonstrate how to disconnect the intramural component of myoma with cold loops; and 3) discuss the advantages of cold loop hysteroscopic myomectomy over conventional slicing.

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