Operative ultrasound using an echogenic loop snare for intrauterine pathology

A technique for resecting intrauterine tissue was performed in nine women, each of whom had intrauterine pathology on sonohysterogram. The uterine cavity was entered with a 12F intrauterine access catheter with a 3-ml balloon that was placed in the cervical canal or lower uterine segment. A 5F echogenic loop snare was passed through the access catheter and resection was attempted under ultrasound guidance. Biopsy samples underwent pathologic examination for definitive diagnosis. Seven of nine patients had adequate resection or biopsy tissue, but in two the loop snare could not secure the base of the lesion. All procedures were well tolerated. Average operating time was about 27 minutes (range 18-43 min), with no complications. Operative ultrasound makes it possible to resect and biopsy intrauterine pathology. In selected patients, this procedure is a cost-effective alternative to hysteroscopy.