New Hysteroscopy Pump to Monitor Real-Time Rate of Fluid Intravasation

This article describes the benefit of monitoring the intravasation rate in addition to the conventional measurement of fluid deficit in hysteroscopic surgical procedures. The intravasation rate is the rate, in milliliters per minute, at which fluid enters the systemic circulation, whereas fluid deficit is the amount of irrigation fluid, in milliliters, already absorbed by the patient. To determine the intravasation rate, a manually operated intravasation monitoring pump was constructed, with which one of us (Dr. Atul Kumar) performed 966 hysteroscopic procedures from May 1993 to February 2010. Because the intravasation rate had to be manually calculated by an assistant, it was decided to replace the assistant with a controller to monitor intravasation rate. The surgical experience gathered from the manually operated pump was used to develop algorithms for the controller. The controller-operated intravasation monitoring pump was constructed, with which 41 hysteroscopic procedures were performed from March 2010 to August 2011. In hysteroscopic procedures, this pump simultaneously displays the real-time intravasation rate and the fluid deficit on an LCD screen.