Many patients with excessive or abnormal uterine bleeding are looking for a
lternatives to ineffectual dilation and curettage or extirpative surgery (i
.e., hysterectomy). The gynecologist-generalist can no longer delay develop
ing the mandatory skills to perform safe, effectual intrauterine surgery. T
o acquire these skills, one needs a sound understanding of hysteroscopic in
strumentation and the biophysical behavior of available energy modalities.
This article reviews the scientific basis for operative hysteroscopic proce
dures using laser energy and monopolar and bipolar electrosurgery.