Radiofrequency Impedance Controlled Endometrial Ablation

Technique 

After dilating the cervix, the NovaSure System is inserted into the uterus. To rule out uterine perforation prior to beginning the procedure, carbon dioxide gas (CO2) is introduced into the cavity .The machine will not turn on if a seal of CO2 has not been created, unless the gynaecologist overrides the system. 

The 3-dimensional gold-plated bipolar mesh electrode is released from within the cathter to expand within the uterus and imitates the shape of uterine cavity. Gently the probe is pushed toward the fundus so that the mesh electrode is accurately positioned within the uterine cavity . Once the electrode is activated with up to 180 W of bipolar power, gentle suction brings the endometrium into close contact with the mesh. This suction also removes debris and allows for more complete desiccation of endometrium. 

The system shuts down automatically when complete desiccation has occurred. 

The average treatment time is just over 1 minute, and the average depth of ablation is 4 to 5 mm.

Once ablation is complete, the mesh electrode is retracted and the catheter is removed . 

The entire procedure takes less than 5 minutes. 

 

Advantages. 

Quick 

Simple 

No endometrial pretreatment is required  

 

Disadvantages. 

Completely blind procedure 

Uterus needs to be of normal shape .

 

Success. 

Bipolar desiccation Novasure achieved higher amenorrhea and reduction of menstrual flow rate than with balloon ablation. 

Patients treated with bipolar desiccation experienced less pain than women who underwent balloon ablation.

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