The mini-resectoscope: a new instrument for office hysteroscopic surgery.
BACKGROUND
Outpatient hysteroscopy has become well-established for the investigation abnormal uterine bleeding. Although "See and Treat" clinics have been widely introduced, the types of procedures offered are limited, and many patients with intrauterine pathology continue to be admitted as in-patients for hysteroscopic surgery. We wanted to investigate the feasibility and acceptability of surgery for small intrauterine lesions without the need for general anesthesia by using a miniature resectoscope.


METHODS
This was a prospective observational study on 30 women with abnormal uterine bleeding associated with endometrial polyps or small (<3 cm) type 0 or 1 submucous fibroids. Hysteroscopic polypectomy (n=26) or myomectomy (n=4) was carried out using a 16 Fr gauge mini-resectoscope.


RESULTS
Ten procedures were carried out in the outpatient clinic and 20 in the operating theatre. Sixteen procedures were done without any anaesthesia and 14 after intra-cervical local anesthetic injections. The polyps and fibroids ranged in size from 1 to 5 cm, and all procedures took less than 15 minutes from the time the vagina was instrumented to the end of surgery. All procedures were completed successfully and were well tolerated with little discomfort. There were no complications.


CONCLUSIONS
The mini-resectoscope appears to be an efficient and acceptable instrument for hysteroscopic surgery and can be used without general anesthesia for minor procedure such as polypectomy and the resection of small submucous fibroids.
Papalampros
Panos
P
University Department of Obstetrics and Gynaecology, The Royal Free Hospital, Hampstead, London, UK.
Gambadauro
Pietro
P
Papadopoulos
Nikolaos
N
Polyzos
Dimitris
D
Chapman
Lynne
L
Magos
Adam
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D020702:Hysteroscopes; D015907:Hysteroscopy; D007889:Leiomyoma / Q000150:complications / Q000601:surgery; D008796:Metrorrhagia; D008875:Middle Aged; D008904:Miniaturization; D011127:Polyps / Q000601:surgery; D014594:Uterine Neoplasms / Q000150:complications / Q000601:surgery*