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Iatrogenic orifice transluminal endoscopic surgery (IOTES): managing uterine perforations at operative hysteroscopy
Alexander Wilfried Huber1, Alessandro Santi, Plamen Tersiev
1Department of Gynecology, University of Bern and University Hospital Bern, Bern, Switzerland.
Objective:
To prove safety and feasibility of an intra-abdominal endoscopic evaluation via an iatrogenic uterine perforation that occurred during operative hysteroscopy.
Design:
Clinical case report.
Setting:
University Hospital.
Patient(S):
A multimorbid woman with postmenopausal bleeding with iatrogenic uterine perforation during hysteroscopic resection of an endometrial polyp.
Intervention(S):
Intra-abdominal endoscopic evaluation via the iatrogenic uterine perforation site with use of a standard diagnostic hysteroscope.
Main Outcome Measure(S):
Visibility, technical feasibility, clinical course, and hematologic follow-up of the patient.
Result(S):
A sufficient assessment of the intra-abdominal cavity and the uterine defect was possible with use of a small-diameter diagnostic hysteroscope during the workup of an iatrogenic uterine perforation. No additional intervention-related side effects occurred.
Conclusion(S):
This technique was safe and feasible to gain operative access to the abdominal cavity, allowing a complete diagnostic intra-abdominal inspection for lesions of the adjacent organs. IOTES bears the potential to become a time-saving low-risk alternative to diagnostic standard laparoscopy.
