Zusammenfassung
Fragestellung: Die operative Hysteroskopie beinhaltet ein größeres Risiko in Bezug auf mögliche
Komplikationen als eine diagnostische Hysteroskopie. Dazu zählen u. a. Perforation,
Blutung, hyponaträmische Hypervolämie. Zur Vermeidung von Komplikationen werden hohe
Anforderungen an den Operateur und die technische Ausrüstung gestellt. Welche Vorteile
bieten neue Instrumente? Material und Methoden: Die bewährten Wege zur Risikoreduktion in der operativen Hysteroskopie werden beschrieben.
Neue Techniken in der operativen Hysteroskopie werden vorgestellt. Ergebnis: Automatische Myomchipabsaugung, bipolare Resektion in isotoner Spüllösung, bipolare
Vaporisation sowie intrauterines Morcellement stellen neue Verfahren in der operativen
Hysteroskopie dar. Schlussfolgerung: Neues Instrumentarium in der operativen Hysteroskopie ist mit spezifischen Vor- und
Nachteilen verbunden. Die neuen Techniken werden in Bezug auf die Risikoreduktion
bei der Resektion submuköser Myome diskutiert.
Abstract
Purpose: There are greater risks of possible complications for operative hysteroscopy procedures
compared to diagnostic hysteroscopy. This includes perforation, bleeding, electrolyte
imbalance, etc. To avoid complications the standards required of the surgeon and his
equipment are high. Do new instruments offer advantages? Material and Methods: The proven techniques for risk reduction in operative hysteroscopy procedures are
described. New instruments are presented. Results: Automatic myoma-chip evacuation, bipolar resection in isotonic fluid, bipolar vaporization
and mechanical morcellation are the new technologies in operative hysteroscopy. Conclusions: New instruments in operative hysteroscopy have specific advantages and disadvantages.
The new techniques are presented and discussed with the aim of reducing risks during
the resection of submucous myomas.
Schlüsselwörter
Hysteroskopie - Myomektomie - Fluid overload - automatische Chipabsaugung
Key words
Hysteroscopy - myomectomy - fluid overload - automatic myoma-chip evacuation
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Dr. med. Achim Niesel
Frauenklinik
Klinik Preetz
Am Krankenhaus 5
24211 Preetz
Email: a.niesel@klinik-preetz.de