Iatrogenic orifice transluminal endoscopic surgery (IOTES): managing uterine perforations at operative hysteroscopy.
OBJECTIVE
To prove safety and feasibility of an intra-abdominal endoscopic evaluation via an iatrogenic uterine perforation that occurred during operative hysteroscopy.


METHODS
Clinical case report.


METHODS
University Hospital.


METHODS
A multimorbid woman with postmenopausal bleeding with iatrogenic uterine perforation during hysteroscopic resection of an endometrial polyp.


METHODS
Intra-abdominal endoscopic evaluation via the iatrogenic uterine perforation site with use of a standard diagnostic hysteroscope.


METHODS
Visibility, technical feasibility, clinical course, and hematologic follow-up of the patient.


RESULTS
A sufficient assessment of the intra-abdominal cavity and the uterine defect was possible with use of a small-diameter diagnostic hysteroscope during the workup of an iatrogenic uterine perforation. No additional intervention-related side effects occurred.


CONCLUSIONS
This technique was safe and feasible to gain operative access to the abdominal cavity, allowing a complete diagnostic intra-abdominal inspection for lesions of the adjacent organs. IOTES bears the potential to become a time-saving low-risk alternative to diagnostic standard laparoscopy.
Huber
Alexander Wilfried
AW
Department of Gynecology, University of Bern and University Hospital Bern, Bern, Switzerland.
Santi
Alessandro
A
Tersiev
Plamen
P
Kuhn
Annette
A
Günthert
Andreas R
AR
Mueller
Michael David
MD
D000369:Aged, 80 and over; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects*; D007049:Iatrogenic Disease; D011127:Polyps / Q000601:surgery; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000601:surgery; D014595:Uterine Perforation / Q000209:etiology* / Q000601:surgery*