Chapter-03 Energy Sources in Operative Hysteroscopy

BOOK TITLE: ISARCON 2017 Manual of Operative Hysteroscopy

1. Tambe Pratik
Publishing Year
Author Affiliations
1. Nirmiti Fertility and IVF, Mumbai, Maharashtra, India, Thane, Maharashtra, India, FOGSI Endocrinology Committee, FOGSI Endocrinology, Committee (2017-2019); MOGS; MSR; AMC, IAGE (2015-2018); MOGS Youth Council, FOGSI Endocrinology Committee (2017-19); Mumbai (Obs-Gyn Society), AMC, MSR, IAGE (2015-18); MOGS Youth Council, FOGSI 2017-19; FOGSI 2017-19, FOGSI Endocrinology Committee (2017–19); MOGS, MSR, AMC, IAGE (2015–18); MOGS Youth Council, Mumbai, Maharashtra, India
Chapter keywords
Bipolar resectoscope, bipolar electrode, distension media, distension medium, radiofrequency electrosurgery, electrolyte-free solution, fluid absorption, traditional monopolar surgery


The bipolar resectoscope has revolutionised the field of hysteroscopic surgery in just a decade. It uses simple, easily available media like normal saline or Ringer’s lactate; ensures good vision owing to less turbidity, is associated with a lower complication rate and does away with the need for using high current settings used in monopolar electrosurgery which may have a long term impact on the endometrium and fertility potential. The bipolar resectoscope is equipped with a working electrode and an inactive, return electrode. Both of these are placed close to each other. Normal saline or Ringer’s lactate may be used as a distension medium. Suitability of electrolyte-free solutions for the performance of radiofrequency electrosurgery with monopolar instrumentation is the principal reason of using it. In case of polyps and fibroids, hysteroscopic bipolar resectoscopy represents a great leap forward with the use of simple, inexpensive, clear, effective distension media like normal saline. The incidence of complications with intravasation of large fluid volumes is low and can be prevented by constant vigilance and the use of monitoring systems.

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