Published online by Cambridge University Press: 10 September 2020
Surgical procedures using electrosurgery can be undertaken within the uterine cavity to address excessive menstrual blood loss and to enhance fertility. The insertion of specialised electrodes down hysteroscopic instruments enables the direct application of electricity to uterine tissue. The electrical energy is transformed into heat and, depending upon how this heat is focused, can be used to cut tissue and excise lesions, or cauterise and ablate tissue (Box 8.1). The larger hysteroscopic resectoscopes with outer diameters of 7 to 8.5 mm are generally, though not exclusively, used during inpatient procedures with a general anaesthetic or regional anaesthesia. The introduction of smaller electrodes (1.67 mm, or 5 Fr) has enabled therapeutic procedures to be undertaken using diagnostic hysteroscopes with an operating channel. This has supported the development of outpatient operative hysteroscopy for the removal of small intrauterine lesions.
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