Intraoperative ultrasound guidance for operative hysteroscopy. A prospective study.
OBJECTIVE
To evaluate the efficacy and safety of ultrasound (US) guidance as compared to laparoscopic monitoring during operative hysteroscopy.


METHODS
Prospective, open study including 81 patients undergoing operative hysteroscopy under US guidance for uterine septum and submucous myoma. Clinical and surgical outcomes were compared with those in an historical control group of 45 patients undergoing the same operation under laparoscopic guidance.


RESULTS
US guidance proved satisfactory in all patients, and there were no complications due to insufficient visualization of the pelvic structures; in no case was conversion to laparoscopic guidance required. US scanning was most useful in determining the outer limit of the intramural component of submucous partial intramural myoma, allowing complete resection. During metroplasty, US guidance allowed extension of the resection beyond the normal limit conventionally defined by hysteroscopy; none required reintervention. By comparison, in the control group, a second attempt was required because the operation was insufficiently radical in four patients.


CONCLUSIONS
US guidance was used successfully as the only visual aid for hysteroscopic surgery, comparing favorably with laparoscopy in terms of efficacy and safety.
Coccia
M E
ME
Department of Gynecology and Obstetrics, University of Florence, Italy.
Becattini
C
C
Bracco
G L
GL
Bargelli
G
G
Scarselli
G
G
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods; D010535:Laparoscopy / Q000592:standards; D007889:Leiomyoma / Q000000981:diagnostic imaging / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D014599:Uterus / Q000002:abnormalities* / Q000000981:diagnostic imaging* / Q000601:surgery