Source: Journal of Minimally Invasive Gynecology; 2017; vol. 24 (no. 7)
Publication Date: 2017
Publication Type(s): Conference Abstract
Abstract:Study Objective: To describe the learning curve and outcomes of Minitouch endometrial ablation cases done by 12 gynaecologists. Design: Electronic discharge summaries and last outpatient clinic letters were analysed of patients who have completed 4-month follow up. Setting: Day case setting of a general hospital within a National Health Service trust. Patients: Patients treated with Minitouch endometrial ablation between January and December 2016. Intervention: Minitouch endometrial ablation procedures. Measurements and Main Results: 48 Minitouch endometrial ablation cases were performed. Four patients are awaiting 4-month follow up. Electronic discharge summaries and last outpatient clinic letters for the remaining 44 patients were analysed. All cases were done in a day case setting by 12 gynaecologists, resulting in an average 3.7 cases per operator. Patients' average age was 42.9 (range 28-53) and their indications were: 39/44 menorrhagia, 2/44 irregular bleeding, and 3/44 metromenorrhagia. Fibroids measuring 9-46 mm were identified during pre-op ultrasound in 15/44 (34.1%) patients, included 11 intramural, 4 sub-mucosal, and 2 sub-serosal. One or more pharmacological treatments had previously failed in 30/44 (68.2%) patients. All patients had normal cavities with an average sounding length of 8.9 cm (range 7-14 cm). 4/44 patients (9.1%) had a history of 1-2 LSCS. Successful resolution of symptoms (amenorrhea, spotting or lighter periods) at 4-months was identified in 36/44 (82%) patients. One of these patients is not completely satisfied and is scheduled for second review. Another is being treated with Esmya. No adverse event was reported. Of the remaining 8/44(18%) patients with persistent symptoms, one patient is under wait and watch, five are receiving pharmacological treatment, one underwent rollerball ablation, and one total laparoscopic hysterectomy. Conclusion: The learning curve for our large team of gynaecologists with varying experience levels was short and consistent as demonstrated by excellent safety and effectiveness outcomes. Minitouch has enabled us to introduce outpatient endometrial ablation service for the first time in our trust.