A Pilot Study Comparing Hysteroscopic Adhesiolysis by Conventional Resectoscope Versus Mini-resectoscope

Roy, Kallol Kumar; Lingampally, Archana; Kansal, Yamini; Bharti, Juhi; Kumar, Sunesh; Vanamail, Perumal; Singhal, Seema; Meena, Jyoti

doi:10.5001/omj.2017.94

Cited by 9 publications

(15 citation statements)

References 26 publications

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“…Despite this practice being associated with a high risk of preoperative pain and vaginal bleeding, 59 the authors did not record any side effects in this series. However, different than in the 5‐mm mini‐resectoscope group, among patients treated with the 9‐mm resectoscope, three cervical lacerations and one uterine perforation occurred 15 …”

Section: Resultsmentioning

confidence: 62%

Efficacy, safety, and feasibility of the treatment of intrauterine pathologies with the mini‐resectoscope: A systematic review

Etrusco,

Laganà,

Chiantera

et al. 2024

Intl J Gynecology & Obste

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BackgroundHysteroscopy represents the gold standard for the diagnosis and treatment of intrauterine pathologies. The advent of the mini‐resectoscope heralded a new era in intrauterine surgery, both in inpatient and outpatient settings.ObjectivesTo evaluate the effectiveness, safety, and feasibility of the mini‐resectoscope for the treatment of intrauterine pathologies.Search StrategyElectronic databases were searched for English‐language trials describing surgical procedures for uterine pathologies performed with a mini‐resectoscope until 30 April 2023.Selection CriteriaRetrospective or prospective original studies reporting the treatment of uterine pathologies with mini‐resectoscope were deemed eligible for the inclusion.Data Collection and AnalysisData about study features, characteristics of included populations, surgical procedures, complications, and results/outcomes were collected.ResultsSeven papers that met the inclusion criteria were included in this systematic review. Quantitative analysis was not possible due to data heterogeneity. A descriptive synthesis of the results was provided accordingly to the pathology hysteroscopically removed/corrected: polyps and myomas, uterine septum, intrauterine synechiae, and isthmocele.ConclusionsThe mini‐resectoscope is poised to play a leading role in hysteroscopic surgery for many pathologies, both in inpatient and outpatient settings. Since some applications of the mini‐resectoscope have not yet been thoroughly investigated, future studies should address current knowledge gaps, designing high‐quality comparative trials on specific applications.

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Section: Resultsmentioning

confidence: 62%

Efficacy, safety, and feasibility of the treatment of intrauterine pathologies with the mini‐resectoscope: A systematic review

Etrusco,

Laganà,

Chiantera

et al. 2024

Intl J Gynecology & Obste

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“…Finally, although not supported by solid literature, another minimally invasive method that is increasingly moving hysteroscopic surgery from the operating room to the outpatient setting is the mini-resectoscope. The mini-resectoscope is a widely used instrument in the hysteroscopic treatment of intrauterine pathology, and its miniaturization would seem to bring with it all the advantages of the conventional resectoscope, together with a procedure that is quicker and well tolerated by the patient and thus conducted without the aid of anesthesia in most cases [83][84][85][86][87][88][89]. Given the increasing use of laser and mini-resectoscope technology in "see and treat" hysteroscopy, future studies should be conducted with the aim of verifying the superiority of one technology over the other in terms of efficacy and safety.…”

Section: Discussionmentioning

confidence: 99%

Use of Diode Laser in Hysteroscopy for the Management of Intrauterine Pathology: A Systematic Review

Etrusco,

Buzzaccarini,

Laganà

et al. 2024

Diagnostics

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Background: Hysteroscopy currently represents the gold standard for the diagnosis and treatment of intrauterine pathologies. Recent technological progress has enabled the integration of diagnostic and operative time, leading to the “see and treat” approach. Diode laser technology is emerging as one of the most innovative and intriguing techniques in this context. Methods: A comprehensive search of the literature was carried out on the main databases. Only original studies reporting the treatment of intrauterine pathologies using diode laser were deemed eligible for inclusion in this systematic review (PROSPERO ID: CRD42023485452). Results: Eight studies were included in the qualitative analysis for a total of 474 patients undergoing laser hysteroscopic surgery. Eighty-three patients had female genital tract abnormalities, 63 had submucosal leiomyomas, 327 had endometrial polyps, and one patient had a scar pregnancy. Except for leiomyomas, whose technique already included two surgical times at the beginning, only seven patients required a second surgical step. Cumulative rates of intraoperative and postoperative complications of 2.7% and 0.6%, respectively, were reported. Conclusions: Diode laser through “see and treat” hysteroscopy appears to be a safe and effective method. However, additional studies with larger sample sizes and improved designs are needed to consolidate the evidence currently available in the literature.

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“…Except for the scar management, another possible reason for the higher AFS scores of electrodes was that the energy-based equipment might cause damage to the endometrium by increasing inflammatory cytokines and promoting adhesion-causing agents such as transforming growth factor-beta, platelet-derived growth factor, and fibroblast growth factor after the operation. A randomized, prospective study revealed that the mini-resectoscope exhibited comparable performances to the conventional resectoscope concerning menstrual and reproductive outcomes while significantly decreasing operative morbidity [ 21 ]. However, we did not observe any differences in adhesion prevention and pregnancy improvement between the treatments of electrode and cold scissor treatments nor between the treatments employing classical and mini-resectoscopes.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Secondary Prevention Following Hysteroscopic Adhesiolysis in the Improvement of Reproductive Outcomes: A Retrospective Cohort Study

Wu,

Fang,

Dong

et al. 2023

JCM

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Intrauterine adhesion (IUA) is primarily caused by endometrial injury, and hysteroscopic adhesiolysis is presently the main treatment. However, postoperative recurrence and poor pregnancy outcomes remain intractable. In this study, we aim to assess the effects of different treatments on clinical symptoms and reproductive outcomes in IUA. This retrospective study was conducted in a tertiary university-affiliated women’s hospital. The study included 1449 consecutive women who desired to have a baby and were diagnosed with IUA through hysteroscopy from January 2016 to December 2021. Patients with IUA underwent hysteroscopic electric resection (E) or cold scissors separation (C), as well as hormone therapy and one or both of the following secondary prevention measures: intrauterine devices (IUD) and hyaluronic acid gel (HA). The pregnancy rate (PR) was significantly higher in the E + IUD + HA (90.23% CI: 85.82, 94.64%) than in other groups (p = 0.000) groups. The rates of full-term birth (p = 0.000) and live birth (p = 0.000) were significantly higher in the E + IUD + HA (67.82% and 68.97%, respectively) and E + HA (62.41% and 63.91%, respectively) groups. Multivariate logistic regression analysis revealed a significantly higher PR in women who received second-look hysteroscopy (OR 1.571, 95% CI: 1.009–2.224, p = 0.013) and E + IUD + HA (OR 4.772, 95% CI: 2.534–8.987, p = 0.000). Combining hysteroscopic electric resection with IUDs and HA gel could prevent adhesion recurrence and improve postoperative pregnancy and live birth outcomes in IUA. Furthermore, postoperative second-look hysteroscopy may increase the PR and shorten the waiting period.

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A Pilot Study Comparing Hysteroscopic Adhesiolysis by Conventional Resectoscope Versus Mini-resectoscope

Abstract: The use of mini-resectoscope for hysteroscopic adhesiolysis is associated with reduced operative morbidity. Use of the mini-resectoscope is an effective and safe alternative to the conventional system.

Cited by 9 publications

References 26 publications

Efficacy, safety, and feasibility of the treatment of intrauterine pathologies with the mini‐resectoscope: A systematic review

Efficacy, safety, and feasibility of the treatment of intrauterine pathologies with the mini‐resectoscope: A systematic review

Use of Diode Laser in Hysteroscopy for the Management of Intrauterine Pathology: A Systematic Review

Comparison of Secondary Prevention Following Hysteroscopic Adhesiolysis in the Improvement of Reproductive Outcomes: A Retrospective Cohort Study

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