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      Hysteroscopic tissue removal systems for the treatment of intrauterine pathology: a systematic review and meta-analysis.

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          Abstract

          The use of mechanical tissue removal systems is more frequently implemented as the first line approach for the treatment of intrauterine pathology. Scientific evidence is provided that their use is easier and faster than the conventional resectoscope. It is necessary to objectively evaluate the results on tissue removal systems for the treatment of endometrial pathology as the reports in the literature are still conflicting.

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          Review of intrauterine adhesions.

          Rebecca Deans, Jason Abbott (2015)
          This article has been produced to review the literature on symptomatic and asymptomatic intrauterine adhesions. Electronic resources including Medline, PubMed, CINAHL, The Cochrane Library (including the Cochrane Database of Systematic Reviews), Current Contents, and EMBASE were searched using the Medical Subject Headings (MeSH), including all subheadings, and the keywords "Asherman syndrome," "Hysteroscopic lysis of adhesions," "Hysteroscopic synechiolysis," "Hysteroscopy and adhesion," "Intrauterine adhesions," "Intrauterine septum and synechiae," and "Obstetric outcomes after intrauterine surgery." The vast majority of evidence in the literature consists of uncontrolled case series, with only intrauterine adhesion barriers being assessed in a randomized controlled format. This article reviews epidemiology, pathologic features, classification systems, and treatments. Seven classification systems are described, with no universal acceptance of any one system and no validation of any of them. Hysteroscopy is the mainstay of both diagnosis and treatment, with medical treatments having no role in management. There is a wide range of treatment techniques with no controlled comparative studies, and assessments are descriptive and report fertility and menstrual outcomes, with more severe adhesions having the worst clinical outcomes. One of the most important features of treatment is prevention of recurrence, with the best available evidence demonstrating that newly developed adhesion barriers such as hyaluronic acid show promise for preventing new adhesions. Crown Copyright © 2010. Published by Elsevier Inc. All rights reserved.
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            Hysteroscopic morcellator for removal of intrauterine polyps and myomas: a randomized controlled pilot study among residents in training.

            Heleen van Dongen, Mark Emanuel, Ron Wolterbeek … (2008)
            The purpose of this randomized controlled study was to compare conventional resectoscopy and hysteroscopic morcellation among residents in training (Canadian Task Force classification I). Sixty women with an intrauterine polyp or myoma were randomized to either hysteroscopic removal by conventional resectoscopy or hysteroscopic morcellation performed by 6 residents in training for obstetrics and gynecology (10 procedures per resident). The mean operating time for resectosocpy and morcellation was 17.0 (95% confidence interval [95% CI] 14.1-17.9, standard deviation [SD] 8.4) and 10.6 (95% CI 7.3-14.0, SD 9.5) min, respectively (p = .008). Multiple linear regression analysis showed that operating time increased significantly, for both resectoscopy and morcellator, when volume of intrauterine disorder increased. The use of the hysteroscopic morcellator reduced operating time more than 8 min in comparison to conventional resectoscopy (p < .001) when correction for volume was applied. Subjective surgeon and trainer scores for convenience of technique on a visual analog scale were in favor of the morcellator. No learning curve was observed. In conclusion, the hysteroscopic morcellator for removal of intrauterine polyps and myomas offers a good alternative to conventional resectoscopy for residents in training.
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              Hysteroscopic morcellation compared with electrical resection of endometrial polyps: a randomized controlled trial.

              Paul Smith, Lee J. Middleton, Mary Connor … (2014)
              To evaluate whether hysteroscopic morcellation or bipolar electrosurgical resection is more favorable for removing endometrial polyps in an office setting in terms of feasibility, speed, pain, and acceptability.
              Article 0 comments Cited 23 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Facts Views Vis Obgyn
                Title: Facts, views & vision in ObGyn
                Publisher:
                ISSN: 2032-0418
                ISSN (Print): 2032-0418
                Publication date (Electronic): Dec 2018
                Volume: 10
                Issue: 4
                Affiliations
                [1 ] Sino European Life Expert Centre-Department of Obstetrics and Gynaecology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
                [2 ] Shanghai Key Laboratory of Gynaecologic Oncology, China.
                [3 ] Department of Obstetrics and Gynaecology, Day General Hospital, Tehran, Iran.
                [4 ] Life Expert Centre, Leuven, Belgium.
                Article
                PMC ID: 6658200
                PubMed ID: 31367293
                SO-VID: 3df56709-0e97-4af1-a313-17b1af7d4810
                History

                Keywords: Hysteroscopic Shaver,Meta-analysis,Myoma,Myosure®,Polyp,System Review,Truclear®
                Data availability:
                Keywords: Hysteroscopic Shaver, Meta-analysis, Myoma, Myosure®, Polyp, System Review, Truclear®

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