Clinical Insights into Operative Hysteroscopy Using the Bigatti Shaver: A Pioneer's Perspective From Indonesia

To evaluate the patient's characteristic, indication, coincide pathology, clinical outcomes, procedural efficiency, and safety profile of operative hysteroscopy performed using the Bigatti Shaver, highlighting its role as a superior alternative to conventional techniques such as D&C.

This descriptive study was purposive sampling with patients who underwent operative hysteroscopy using the Bigatti Shaver at Harapan Kita National Women and Children Health Centre from 2016 to 2024. Data were collected on patient demographics, indications of the procedure, procedure duration, histopathology result, and postoperative outcomes.

A total of 125 patients were included in the study, with a mean age of 35.7 years old. The most common indications for hysteroscopy endometrial polyp 75 (60%), submucousal fibroid 13 (10.4%), ROPC 12 (9.6%), asherman syndrome 6 (4.8%), endometritis 5 (4%), endometrial hyperplasia 4 (3.2%), submucousal fibroid + endometrial polyp 3 (2.4%), uterine septum 2 (1.6%), arcuate uterus 2 (1.6%), submucousal fibroid + endometrial hyperplasia 2 (1.6%), cesarean scar pregnancy 1 (0.8%). The mean operative time was 17'6″, with the following order: Fibroid 40'4″, polyp and fibroid 31'6″, polyp 6'3″, Uterine Anatomy Abnormalities 5'5″, and hyperplasia endometrium 2'. From initial examination, several coincide diagnosis was discovered, including cesarean scar pregnancy, dermoid cyst. No complication was found. The histopathology result was in accordance with the preoperative diagnosis, however 2 patient revealed a endometrial malignancy. Postoperative recovery was uneventful in all of the patients, and the majority reported significant symptomatic improvement at follow-up.

Operative hysteroscopy using the Bigatti Shaver is an effective and safe technique for managing various intrauterine pathologies. Its ability to provide precise tissue resection with relatively minimal complications makes it a valuable tool in modern gynecologic surgery. Further studies are recommended to compare its outcomes with other hysteroscopic systems.