Marco Zaccaria: Why Distension Media Selection Matters in Modern Hysteroscopy
Marco Zaccaria, Global Product Manager at ESGE European Society Gynecology Endoscopy, shared a post on LinkedIn:
“What type of medium do you use to distend the uterine cavity?
Distension media for hysteroscopy are liquid substances used to separate the uterine walls, providing the surgeon with a clear working space and optimal visual field
The choice of medium depends primarily on whether the procedure is diagnostic or operative, and what energy source (monopolar vs. bipolar electrosurgery) is utilized
Our HS AMICA system is compatible with the most widely used operating channels on the market, and depending on whether a monopolar electrode needle or a bipolar microwave antenna is used, the appropriate distension method can be selected:
1. For MW bipolar antennas low-viscosity isotonic fluids (Electrolyte-Containing) as like normali saline that provides excellent visualization and carries a lower risk of severe hyponatremia
2. For RF monopolar needles, low-viscosity hypotonic fluids (Electrolyte-Free) as like:
- 1.5% Glycine: Commonly used with monopolar resectoscopes, but carries a high risk of ‘TURP syndrome’ if fluid limits are breached
- 3% Sorbitol: Another non-conductive option that carries a similar risk of fluid overload and hyponatremia
- 5% Mannitol: An isotonic alternative to glycine or sorbitol for monopolar energy, which may reduce the risk of severe hyponatremia during large-volume absorption”
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