Office hysteroscopy: back to the future!

Mak, Jason; Imran, A; Burnet, S.

doi:10.1080/13697137.2020.1750589

Cited by 6 publications

(4 citation statements)

References 26 publications

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“…Hysteroscopy is the gold standard for diagnostic and therapeutic tools used in the evaluation and treatment of conditions affecting the uterine cavity, such as abnormal uterine bleeding and infertility [ 1 – 3 ]. Conventional resectoscope hysteroscopy is the most common procedure performed to remove endometrial polyps using bipolar or monopolar electrical energy.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of whether there is residual polyp tissue after hysteroscopic morcellation at Cam and Sakura City Hospital: a retrospective cohort study

Sivas,

Ohanoglu Cetinel,

Arslan

2024

BMC Women's Health

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Background In polypectomy with mechanical hysteroscopic morcellators, the tissue removal procedure continues until no polyp tissue remains. The decision that the polypoid tissues were removed completely is made based on visual evaluation. In a situation where the polyp tissue was visually completely removed and no doubt that the polyp has been completely removed, short spindle-like tissue fragments on the polyp floor continue in most patients. There are no studies in the literature on whether visual evaluation provides adequate information at the cellular level in many patients in whom polypoid tissues have been determined to be completely removed. The aim of the present study was to analyze the pathological results of the curettage procedure, which was applied following the completion of polyp removal with operative hysteroscopy, and to evaluate whether there was residual polyp tissue in the short spindle-like tissue fragments that the mechanical hysteroscopic morcellator could not remove. The secondary aims of this study were to compare conventional loop resection hysteroscopy with hysteroscopic morcellation for the removal of endometrial polyps in terms of hemoglobin/hematocrit changes, polypectomy time and the amount of medium deficit. Methods A total of 70 patients with a single pedunculate polypoid image of 1.5-2 cm, which was primarily visualized by office hysteroscopy, were included in the study. Patients who had undergone hysteroscopic polypectomy were divided into two groups according to the surgical device used: the morcellator group (n = 35, Group M) and the resectoscope group (n = 35, Group R). The histopathological results of hysteroscopic specimens and curettage materials of patients who had undergone curettage at the end of operative hysteroscopy were evaluated. In addition, the postoperative 24th hour Hb/HCT decrease amounts in percentage, the polypectomy time which was measured from the start of morcellation, and deficit differences were compared between groups. Results In total, 7 patients in the morcellator group had residual polyp tissue detected in the full curettage material. The blood loss was lower in the morcellator group than in the resectoscope group (M, R; (-0.07 ± 0.08), (-0,11 ± 0.06), (p < 0.05), respectively). The deficit value of the morcellator group were higher (M, R; (500 ml), (300 ml), (p < 0.05), respectively). The polypectomy time was shorter in the morcellator group (M, R; mean (2.30 min), (4.6 min), (p < 0.05)). Conclusions Even if the lesion is completely visibly removed during hysteroscopic morcellation, extra caution should be taken regarding the possibility of residual tissue. There is a need for new studies investigating the presence of residual polyp tissue.

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Section: Introductionmentioning

confidence: 99%

Evaluation of whether there is residual polyp tissue after hysteroscopic morcellation at Cam and Sakura City Hospital: a retrospective cohort study

Sivas,

Ohanoglu Cetinel,

Arslan

2024

BMC Women's Health

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“…With the miniaturization of operative scopes and introduction of new surgical instruments, the outpatient operative hysteroscope is fast surpassing traditional in-patient hysteroscopy performed in an operating theatre [3]. This is due to the fact that office hysteroscopy offers several advantages, including shorter operating times, quicker postoperative recovery, not requiring hospital admission, no risks associated with general anaesthesia and its low cost when compared to inpatient hysteroscopy [4].…”

Section: Introductionmentioning

confidence: 99%

“…Hysteroscopy in any setting is a safe procedure and surgical complication rates seem to be the same for office hysteroscopy and inpatient hysteroscopy [4]. As this technique moves into an office setting with more operative procedures being performed as an outpatient procedure, it is important to improve the training presently offered.…”

Section: Introductionmentioning

confidence: 99%

Operative Hysteroscopy Complications

Serranito¹

2023

Updates in Endoscopy

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Operative hysteroscopy is a minimally invasive gynaecological procedure and is considered the gold standard for the treatment of intracavitary uterine pathology. Over the last decades, with the development of new surgical instruments, the popularity of this technique has increased with gynaecologists across the world. However, this minimally invasive technique can be associated with rare but serious complications that can lead to severe morbidity and, if not treated adequately in some cases, ultimately lead to mortality. Any gynaecologist using this procedure should not only train in the operative technique but should also acquire knowledge on what type of complications may arise whilst performing an operative hysteroscopy. The following chapter explores the diagnosis of complications associated with the operative hysteroscopy and management options.

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“…Initial terminology of word Hysteroscopy depicts the Greek words hysteron which defines uterus and scopy which defines to look. 1 Before the establishment of this endoscopic technique, the investigation of endometrial cavity was taking place only by dilatation and curettage. This intervention reflected a blind surgical procedure with many potential intraoperative complications such as perforation of uterine wall, vaginal bleeding and diffuse endometritis.…”

Section: Introductionmentioning

confidence: 99%

See and treat hysteroscopy. Future challenges and new prospective

Sofoudis,

Fani,

Orestis

et al. 2023

OGIJ

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Rapid development of technology, which has been achieved over the last decade, has helped decisively in the investigation and treatment planning of pathological conditions in the field of endoscopy and more specifically of hysteroscopic gynecological procedure. Through endless efforts in the wider medical field, hysteroscopic access of the endocervix and at the same time of the endometrial cavity was established both on a diagnostic and invasive level as an integral tool of gynecological surgery, revealing great sensitivity but also great specificity. Hysteroscopic intervention provides the possibility of direct visual imaging of endocervix and endometrial cavity and directly optically guided biopsies for histological confirmation. Globally, performance of hysteroscopy at the level of an outpatient clinic (office hysteroscopy) has a success rate of 98% and is considered a more valid method compared to diagnostic curettage. Design of increasingly flexible and smaller diameter endoscopic tools achieved the possibility of reviewing the endometrial cavity at the level of an outpatient office (office hysteroscopy), without analgesia. A study included cases of patients in whom both diagnostic and therapeutic approach were performed. Our study is focused on specific cases involving hysteroscopic procedures performed at the level of an outpatient clinic as part of an initial diagnostic examination and concurrently as part of an invasive treatment result. As culmination of all above was established hysteroscopic diagnosis and treatment in one session. (See and Treat Hysteroscopy). The aforementioned led to the development of hysteroscopic diagnosis and treatment in the context of See and Treat Hysteroscopy.

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Office hysteroscopy: back to the future!

Cited by 6 publications

References 26 publications

Evaluation of whether there is residual polyp tissue after hysteroscopic morcellation at Cam and Sakura City Hospital: a retrospective cohort study

Evaluation of whether there is residual polyp tissue after hysteroscopic morcellation at Cam and Sakura City Hospital: a retrospective cohort study

Operative Hysteroscopy Complications

See and treat hysteroscopy. Future challenges and new prospective

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