Focused Trial And Error
Remember me Create an account Forgotten password Activate/Link subscription OpenAthens login Advertisement Advertisement Home News Focus 7 November 1992 Focus: Trial and error in the operating theatre - An enlightened trial and error succeeds over the planning of the lone genius operation for treating heavy periods is now widely used despite doubts over peter skillman its safety. Are new surgical techniques properly evaluated? By CATHY READ Up until the last few years, many ideo thousands of women in Britain underwent hysterectomies every year to cure heavy periods. Then endometrial ablation arrived on the scene, which was much less invasive, required only a short stay in hospital and appeared to have fewer side effects. The technique is now routine in half of all hospitals with gynaecological departments and between 8000 and 12 000 women underwent the treatment last year. But leading gynaecologists are concerned by the phenomenal growth in popularity of endometrial ablation, not least because surgeons may use the technique without any formal training or supervision. ‘(Some) gynaecologists went off and taught themselves. As a result, there have been a number of serious complications from the technique,' says Victor Lewis, President of the British Society of Gynaecological Endoscopy. Four or more women are believed to have died as a result of the operation. ‘I think four is a conservative figure, but I fear it may be more. I know of life-threatening complications which were not reported,' says Alan Gordon, a former president of the society. The uncertainty over endometrial ablation and other minimally invasive techniques, such as ‘keyhole' surgery, has led to calls for new surgical procedures to be evaluated as rigorously as new drug treatments and for surgeons to become accredited in new techniques. Advertisement Early next year, at least one of five large randomised controlled trials are due to publish their results. This type of trial is the ‘gold standard' used for more than 40 years to compare new drugs with existing treatments, but normally before the drugs are made widely available. Endometrial ablation and a family of related techniques destroy the end
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