Published online by Cambridge University Press: 10 September 2020
Endometrial ablation (EA) is a minimally invasive surgical intervention that aims to reduce heavy menstrual bleeding (HMB) by destroying functionally active endometrial glands within the endometrium and the superficial myometrium, including the deep basal glands. To prevent regeneration and stop menstruation this destruction should be to a depth of 5 mm. In the past, destruction of the endometrium required an operating hysteroscope. Endometrial tissue was either removed using an electrical cutting loop or destroyed by applying thermal energy to induce necrosis using an electrical ‘rollerball’ or laser fibre. These first-generation techniques have largely been superseded by second-generation techniques that comprise semi-automated global ablative systems using a variety of energy sources to thermally ablate the endometrium. These systems require less operator skill, are less likely to require general anaesthesia, are quicker to perform and offer enhanced safety with no loss in effectiveness.
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