Feasibility and complications in bipolar resectoscopy: preliminary experience

Area of Science:

• Gynecology
• Minimally Invasive Surgery
• Hysteroscopy

Background:

• Operative hysteroscopy is a key procedure for diagnosing and treating intrauterine pathologies.
• Traditional resectoscopes can require significant cervical dilatation, potentially leading to complications.
• Advancements in instrumentation aim to improve safety and efficiency in hysteroscopic procedures.

Purpose of the Study:

• To evaluate the efficacy and safety of the new 22 Fr bipolar resectoscope (BR) in operative hysteroscopy.
• To compare the performance of the 22 Fr BR against the existing 26 Fr BR.

Main Methods:

• A prospective observational study involving 140 patients undergoing hysteroscopic procedures for endocavitary pathologies.
• Patients were treated using either the 22 Fr BR or the 26 Fr BR.
• Data collected included patient characteristics, surgical indications, operative time, and complication rates.

Main Results:

• The 22 Fr BR was used in 115 patients for procedures including metroplasty, polypectomy, and myomectomy.
• The 26 Fr BR was used in 25 patients for polypectomy and myomectomy.
• Mean cervical dilatation time was significantly lower with the 22 Fr BR (57 sec) compared to the 26 Fr BR (102 sec) (p=0.034).
• Complication rates were significantly lower with the 22 Fr BR (0.8%) versus the 26 Fr BR (16%) (p=0.002), including uterine perforation, bleeding, intravasation syndrome, and cervical laceration.

Conclusions:

• Bipolar resectoscopy is a feasible and safe technique for operative hysteroscopy.
• The 22 Fr BR is preferable to the 26 Fr BR due to reduced cervical dilatation requirements.
• The 22 Fr BR offers a significant advantage in limiting operative time and minimizing complications.