uterine polyps: modern management
TRANSCRIPT
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Hysteroscopic polypectomy– New approaches
Mahantesh KaroshiConsultant Gynaecologist
Royal Free London NHS Foundation Trust
Barnet Hospital
London, UK
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• 33% of GOPD attendance are AUB related
• Of these, 10-30% will be due to endometrial polyps
• In 10% of women with PMB, endometrial cancer is the causative factor
Scale of the problem
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Existing technique- Monopolar hysteroscopic resection
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The current model of care at BCFH
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The proposed model of care
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NICE-2013
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Product comparison
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Truclear Vs Myosure
Polyp Myosure
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Current Care Model
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Proposed Model of Care
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Cost Effectiveness (1)
Running Cost per Procedure
Reimbursement per Procedure
TRUCLEAR Cost
Profit/Loss Per Procedure
Number of Procedures per year
Profit/Loss per year
Theatre: Polypectomy £700 £893 £158 450 £71,100
Outpatient: Polypectomy £150 £1,197 £296 £716 450 £322,327
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Obstet Gynecol -2014
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RCT study conclusions
• Feasible and safe
• Quicker (5mins Vs 10mins)
• Less painful
• Increased complete removal (98% vs 83%)
• Truclear– less complex movements.
– Simultaneous cutting and removal of chips
– Mechanical cutting less irritating than electrical cutting
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TRUCLEAR vs. Myosure
MyoSure Lite
TRUCLEAR INCISOR Plus Blade 2.9
Scope diameter 6.25mm 5.0mm without sheath 5.6mm with sheath
Blade diameter 3.0mm 2.9mm
Visualization • Rod lens hysteroscope
• Blade-only outflow
• Fiber optics hysteroscope
• Continuous outflow – blade and sheath
Fluid Management System
• Aquilex Fluid System
• Cost per procedure £70
• Bag on a pole• Cost per
procedure £5
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Thank you
Do not expect different results if you are doing the same thing over and over again
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