Rollerball endometrial ablation.

Abstract

Attempts at endometrial destruction to treat abnormal uterine bleeding unresponsive to medical therapy in women at risk to hysterectomy are not new. However, a practical and effective method was not introduced until the early 1980s, when the Nd:YAG laser was used through the hysteroscope for endometrial photocoagulation. Soon after, electrosurgery proved to be a good alternative for endometrial ablation, either by resection, coagulation, or both. Because of its relative simplicity, effectiveness, and low complication rate, the rollerball endometrial ablation has been attractive to physicians and patients alike as a good alternative to endometrial laser ablation. The overall results, particularly in properly selected patients who have been hormonally suppressed to thin the endometrium and permit good tissue penetration of the electrosurgical energy, have been most satisfactory.