title: Iatrogenic orifice transluminal endoscopic surgery (IOTES): managing uterine perforations at operative hysteroscopy.
abstract: 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.
authors.affiliation: Department of Gynecology, University of Bern and University Hospital Bern, Bern, Switzerland.
authors.forename: Alexander Wilfried
authors.initials: AW
authors.lastname: Huber
authors.forename: Alessandro
authors.initials: A
authors.lastname: Santi
authors.forename: Plamen
authors.initials: P
authors.lastname: Tersiev
authors.forename: Annette
authors.initials: A
authors.lastname: Kuhn
authors.forename: Andreas R
authors.initials: AR
authors.lastname: Günthert
authors.forename: Michael David
authors.initials: MD
authors.lastname: Mueller
mesh_terms: 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*