GYNECARE VERSAPOINT™ Bipolar Electrosurgery System

GYNECARE VERSAPOINT^® Bipolar Electrosurgery System is an innovative electrosurgical system which operates in normal saline as distension medium. This breakthrough technology can enable to treat benign intrauterine pathology such as myomas, polyps, adhesions and septa both in outpatient and inpatient settings.

GYNECARE VERSAPOINT^® Bipolar Hysteroscopic System offers a double range of electrodes:

• 5 Fr electrodes such as Twizzle, Spring and Ball which work in an outpatient setting without anaesthesia and/or analgesia. 5 Fr electrodes are used with continuous flow mini-hysteroscopes such as GYNECARE VERSASCOPE^® through an operative working channels
• 24 Fr electrodes such as Bipolar Loop and Vaporizing Bar which work in inpatient setting in the operating theatre in combination with the GYNECARE VERSAPOINT^® Resectoscope system.

Electrodes deliver bipolar energy to vaporize, cut and desiccate tissue. Each electrode provides a range of tissue effects to give a variety of surgical technique options.

Energy is delivered from the generator to the tissue through the active electrode. In the vaporization mode, the generator controls the creation of a "vapour pocket," or steam bubble, which upon contact with tissue causes instantaneous cellular rupture characteristic of vaporisation.

The energy then seeks the path of least resistance - through the saline distention media, to the return electrode and back to the generator.

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GYNECARE VERSAPOINT® has many advantages but its most prevalent benefit is the fact that it can be used in an outpatient setting thanks to innovative 5 Fr electrodes.

This not only provides cost-minimisation within the healthcare sector but it means a faster recovery time for patients.

A clinical trial into the cost minimisation analysis when comparing ‘outpatient see and treat’ hysteroscopy service with traditional hysteroscopy services in the English NHS found that ‘outpatient see and treat’ had the lowest costs per patient when compared to more traditional methods such as ‘outpatient and referral service’ and ‘GA see and treat service’. The study was also able to administer a successful diagnostic hysteroscopy examination to 96.2% of the patients. In the long term, this service model may reduce the total cost of care for women referred for a hysteroscopy².

A study into the outpatient versus daycase for endometrial polypectomy using GYNECARE VERSASCOPE® and GYNECARE VERSAPOINT® found that 75% who received an endometrial polypectomy described the outpatient procedure to having mild or moderate intraoperative discomfort³. However, 58% of outpatients were pain free for the remainder of the day as opposed to 28% in the daycase patients³. These are particularly encouraging results that are further reinforced by the fact that endometrial polypectomy under direct hysteroscopic vision is more likely to completely remove the endometrial basalis layer and thus further reduces the risk of recurrence in comparison to the blind removal used in the more traditional method of using polyp forceps³.

The following day after the endometrial polypectomy, the same study found that 74% of those patients who received the outpatient treatment, described no pain when compared to the low number of 41% of daycase patients³. As a result, 90% of these outpatient patients used positive adjectives to describe the procedure as opposed to 67% of daycase patients, with 82.4% of daycase patients stating that they would prefer to undergo outpatient endometrial polypectomy if required again in the future³.

In saying that, currently 90% of gynaecologists remove intrauterine polyps in an inpatient setting using blind avulsion under general anaesthetic⁴. Not only does performing endometrial polypectomy in an outpatient setting reduce the risk of reoccurrence, it means that the patient will experience less time away from home, faster return to preoperative fitness and it obviates the needs and costs required for a daycase procedure under general anaesthesia.

Several clinical trials have found that an outpatient setting as opposed to a daycase setting, for certain procedures, substantially reduces the cost to the health service and thus highlights a need to move more towards ‘patient led services’ that where applicable are performed in an outpatient setting^2,5,6.

<sub>1. Davis JA,Miller CD. Fluid infusion during hysteroscopic surgery. In:Lewis BV,Magos AL,eds. Endometrial Ablation. London,UK: Churchill Livingstone;1993:41-56.
2. Saridogan, E., Tilden, D, Davis, N., Sykes, D, Subramanian, D. Cost minimisation analysis comparing outpatient see and treat hysteroscopy service with traditional hysteroscopy service models in the National Health Service England. University college London hospital, London, UK.
3. Marsh, F.A., Rogerson, L.J., Duffy, S.R.G. 2006. A randomised controlled trial comparing outpatient versus daycase endometrial polyperctomy. Academic Department of Obstetrics and Gynaecology, St James’s University Hospital, Leeds, UK
4. Marsh, FA, Kremer, SD, Duffy, S. A randomized controlled trial analyzing the cost of outpatient versus daycase hysteroscopy. BJOG 2004;111:243-8.
5. Clark, J., Goodwin, J., Khan, K., Gupta, J. Ambulatory endoscopic treatment of symptomatic benign endometrial polyps: a feasibility study. Gynaecol Endosc 2002;11:91.
6. Clark, TJ., Khan, KS., Gupta, JK. Current practice for the treatment of benign intrauterine polyps: a national questionnaire survey of consultant gynaecologists in UK. Eur J Gynecol Reprod Biol 2002; 103</sub>

Links to:

http://www.womenshealthsolutions.co.uk/

http://www.womenshealthsolutions.ie

http://www.womenhealth.ch

http://www.gynecare.de

http://www.gynecare.at

http://www.saudedamulher.com.pt