Outpatient hysteroscopic polypectomy: bipolar energy system (Versapoint®) versus diode laser – randomized clinical trial

Abstract

Objective: To compare the resection of endometrial polyps with two different devices: the Versapoint biopolar electrode and the Diode Laser.

Methods: One hundred and two patients diagnosed with endometrial polyps were randomly assigned to undergo hysteroscopic polypectomy: one group (n = 52) performed with Versapoint bipolar electrode through a 5Fr working channel and the other group with Biolitec Diode Laser (n = 50) using a specific fiber for polyps in a 7Fr working channel. All cases were managed on an outpatient basis, without anesthesia and using a rigid 30^o hysteroscope and saline solution as a distention medium.

Main outcome measures: Complete resection rate, operative time, complications, intraoperative pain and relapse rate after three months.

Results: Intraoperative pain and polyp resection time was similar in both groups. Upon second look hysteroscopy at 3–month, a higher percentage of women of the Versapoint group presented polyp relapse (32.6 versus 2.2%, p = 0.001). Elimination of the polyp after incomplete resection was higher in the Laser group. A significantly higher number of patients in the Laser group considered the procedure to be highly recommendable (p = 0.02).

Conclusion: Polypectomy with Diode Laser resulted in fewer relapses and a higher procedure satisfaction rate as compared to Versapoint.

Chinese abstract

目的：两种不同设备Versapoint双极性电极与激光二极管行子宫内膜息肉切除手术情况的比较。

方法：102名确诊为子宫内膜息肉需行宫腔镜息肉切除术的门诊患者随机分为两组：一组（n = 52）采用5Fr微型工作通道孔的双极电手术系统；另一组采用具有特殊光纤的Biolitec半导体激光系统，工作通道孔为7Fr。所有患者均于门诊处理，无需麻醉、使用传统30°宫腔镜，膨宫介质为生理盐水。

主要观察指标：息肉完整切除率、手术时间、并发症、术中疼痛及术后三个月复发率。

结果：两组术中疼痛和手术时间无明显差别。术后3个月再次行宫腔镜检查，Versapoint组妇女息肉复发率较高（32.6 与 2.2%, p = 0.001）。而激光组出现较高的息肉未完整切除（息肉残留）情况。激光组绝大多数患者高度推荐使用Biolitec半导体激光系统（p = 0.02）。

结论：与Versapoint双极电手术系统相比，Biolitec半导体激光系统在宫腔镜息肉切除术中，复发率较低，术中患者满意率较高。

• Diode Laser
• endometrial polyp
• hysteroscopy
• polypectomy
• Versapoint

Acknowledgements

The authors thank the members of the hysteroscopy unit at the Reina Sofia hospital in Córdoba.

Declaration of interest

The authors report no conflicts of interest. Additionally, the authors have no commercial, proprietary, or financial interest in the products or companies described in this article.