LiNA OperaScope^TM for microwave endometrial ablation for endometrial polyps with heavy menstrual bleeding: A case...

The procedure for microwave endometrial ablation (MEA) follows established MEA practice guidelines but requires hysteroscopic observation of the uterine lumen before and after MEA. When a luminal uterine lesion is recognized, its removal requires preoperative dilation of the cervix because the outer diameter of a conventional rigid hysteroscope is 8.7 mm. Recently, a fully disposable rigid hysteroscope (LiNA OperaScope^TM) with a narrow diameter (4.4 mm) and forceps capable of extracting endometrial lesions has become available.

Here, we report a case of heavy menstrual bleeding (HMB) complicated by endometrial polyps where MEA was performed after removing endometrial polyps using the LiNA OperaScope^TM device. A 48-year-old woman with three prior pregnancies and three deliveries was referred to our hospital for further examination and treatment after being diagnosed with HMB 2 years earlier. The patient underwent MEA following endometrial polypectomy using LiNA OperaScope^TM. After MEA, endometrial cauterization was again examined using the LiNA OperaScope^TM, and the procedure was completed. No preoperative cervical dilation was performed. The patient's clinical course was favorable, and she was discharged 3 h after surgery. One month after surgery, menstruation resumed, and both HMB and dysmenorrhea improved markedly from 10 preoperatively to 1 postoperatively, as assessed subjectively using the visual analog scale. The patient's postoperative course was uneventful with no complications.

LiNA OperaScope^TM can be a minimally invasive treatment for MEA of HMB with uterine lumen lesions.