Hysteroscopic Myomectomy of Large Submucous Myomas in a 1-Step Procedure Using Multiple Slicing Sessions Technique

Slice and Excise Technique in Hysterscopic Myomectomy for Large G0 Submucous Myoma

“…Studies suggested the use of preoperative medical treatment with gonadotropin-releasing hormone (GnRH) agonists in facilitating surgery and improving the long-term result of hysteroscopic myomectomy. Another study suggested multiple slicing sessions technique with hydromassage [23]. Also, laser usage was suggested, in which the fibroid was first cut into pieces until the residual fibroids could be extracted by forceps [24].…”

Minimally Invasive Approaches to the Surgical Management of Fibroids

“…This technique involves alternating 5 to 10 minutes of slicing with episodes of stopping/restarting distension fluid infusion as well as bimanual uterine massage to stimulate uterine contractions and induce extrusion of the fibroid into the uterine cavity for further slicing. 52 Mazzon et al developed the cold loop HM to minimize thermal damage of healthy myometrium surrounding the fibroid, reporting benefits for decreasing intrauterine synechiae formation. Conventional slicing is used to remove the intracavitary component of a fibroid until a cleavage plane between the fibroid and myometrium is identified; at this point, a cold mechanical loop is used to enucleate the intramural component of the fibroid.…”

Hysteroscopic excision of symptomatic myometrial adenomyosis: feasibility and effectiveness

“…Recently, with decrease of onset age and the increasing desire to preserve the uterus even among older women, conservative surgery has emerged as a popular treatment. Hysteroscopy has replaced old and/or invasive techniques, and has become a standard in gynaecological practice and has considerable advantages, such as less postoperative pain, shorter hospital stay and shorter recovery time . Hysteroscopic surgery has a better ability to remove submucous myomas and partially intramural myomas, keeping the outer myometrium intact and preserving the uterus .…”

“…Hysteroscopy has replaced old and/or invasive techniques, and has become a standard in gynaecological practice and has considerable advantages, such as less postoperative pain, shorter hospital stay and shorter recovery time . Hysteroscopic surgery has a better ability to remove submucous myomas and partially intramural myomas, keeping the outer myometrium intact and preserving the uterus . However, only a few case reports have described hysteroscopic excision of myometrial adenomyomas or the diagnosis of adenomyosis by biopsy .…”

“…4 Hysteroscopic surgery has a better ability to remove submucous myomas and partially intramural myomas, keeping the outer myometrium intact and preserving the uterus. 4,5 However, only a few case reports have described hysteroscopic excision of myometrial adenomyomas or the diagnosis of adenomyosis by biopsy. [6][7][8][9][10] Here, we introduced transcervical resection (TCR) of intramural adenomyosis.…”