Hysteroscopic fluid management.

Many of the technical difficulties and hazards associated with operative hysteroscopy revolve around management of the liquid distending medium. For the nurse, this involves vigilance in determining when the reservoir bag needs to be changed and when the return canister is full, and the task of calculating inflow-outflow deficits. The last is made more difficult by the fact that 3-L bags of dilute sorbitol or glycine most often used in hysteroscopy are not filled precisely, and readings of residual reservoir volume and canister levels are often made in darkened operating rooms. For the surgeon, the first issue is to achieve satisfactory intrauterine visualization that relates to the pressure and the flow of medium. Both surgeon and patient are understandably concerned about problems of excessive absorption of water from the electrolyte-free medium causing potentially life-threatening hyponatremia and hypervolemia. A system to manage hysteroscopic fluid was developed that addresses these concerns.