Endometrial ablation is a surgical procedure intended to remove or destroy the lining of the uterus (endometrium) as safely and completely as possible.
Endometrial ablation is a treatment alternative to hysterectomy (removal of the uterus) in cases of abnormal bleeding coming from the uterus. In most cases, this means abnormally heavy menstrual periods. When such problems occur, various tests are done prior to treatment to search for underlying causes for the disorders or other medical problems associated with bleeding. See endometrial biopsy, ultrasonography, and diagnostic hysteroscopy.
An instrument called a hysteroscope is placed through the vagina into the cervix (neck of the womb). A sterile liquid flows through the hysteroscope in order to distend the cavity of the uterus so that a clear view can be obtained of the entire surface of the endometrium. A video camera is attached to the end of the hysteroscope, and the uterine cavity is seen on a video monitor. The ablation is done using an instrument, which passes through the hysteroscope. This consists of an attachment, which is moved back and forth past the end of the hysteroscope, always directly, in the view of the surgeon. A variety of end attachments (wire loops, metal balls, metal bars) are used to perform the operation. With a clear and magnified view of the endometrium and the movable attachments just described, an electrical current is passed through the instrument and, as it moves along the surface of the endometrium, the endometrium is removed, or cauterized.
Sometimes, benign outgrowths from the endometrium (polyps or small fibroids) are seen and can be removed at the time of the procedure. This is referred to as “hysteroscopic resection of submucosal fibroids or polyps”. In these instances, if a polyp or fibroid is seen in the endometrial cavity, the surgeon may remove all or part of the abnormality by cutting into it and withdrawing it from the uterus. This area is then ablated as described above. This is referred to resection of intrauterine disease.