Improved Hysteroscopic Resection of Endometrial Polyps Using 6-Fr Micro-Scissors and Forceps

Summary

The novel technique presented here employs a combination of 6-Fr micro-scissors and forceps for hysteroscopic treatment of endometrial polyps, demonstrating encouraging outcomes for infertile patients afflicted with this condition.

Abstract

Endometrial polyps commonly contribute to female infertility, and hysteroscopic resection is the established surgical approach for their treatment. Numerous resection methods are available, with the most used and cost-effective options being cold resection employing micro-scissors or hot resection using an electric loop. However, both methods involve sharp resection, posing a challenge in achieving complete polyp removal while avoiding damage to the uterine endometrium. To address this issue, this study proposes an innovative approach: the combined use of the 6 Fr micro-scissors and forceps under hysteroscopy. The method entails utilizing 6 Fr micro-scissors to initially remove large polyps, followed by using 6 Fr micro-forceps to extract the remaining polyp tissue expeditiously and bluntly near the basal layer of the endometrium. This approach not only prevents surgical damage to the basal layer of the endometrium but also mitigates the risk of residual polyps resulting from incomplete resection. This method is particularly suitable for women with fertility requirements, offering additional considerations for the selection of treatment options for endometrial polyp resection.

Introduction

Endometrial polyps are abnormal tissue growths in the uterine lining with significant implications for fertility and reproductive health¹. The estimated incidence rate of endometrial polyps is approximately 35% among patients with infertility², though this figure may vary. These polyps can disrupt embryo implantation by inducing structural deformities in the uterine cavity and impacting the endometrium's ability to support implantation^3,4,5,6. While hysteroscopic surgery is a common procedu....

Protocol

This prospective observational study, involving outpatient hysteroscopy surgery patients, was conducted from March to December 2023. It was approved by the hospital's ethics committee of Shanghai JiAi Genetics & IVF Institute (ethics file number: JIAI E2020-09). All participants provided informed consent prior to inclusion in the study.

1. Patient selection and preparation

1. Patient eligibility
   1. Inclusion criteria: include patients with primary or .......

Discussion

Our research presents a novel surgical technique for removing endometrial polyps without cutting or causing electrical damage to the uterine endometrium, which is especially beneficial for women with fertility concerns. Sharon et al. introduced a similar technique using a non-electric loop for polyp excision¹¹, demonstrating its efficacy and safety. However, the traditional resectoscope has a larger diameter¹², necessitating cervical dilation and potentially increasing the .......

Materials

Name	Company	Catalog Number	Comments
Grasping Forceps	ShenDa	X5164B
Hysteroscope Lens	ShenDa	J0122A
Hysteroscopic Infusion Set	ShenDa	T7511
IMAGE 1 S CONNECT	KARL STORZ	TC200
IMAGE1 HD	KARL STORZ	H3-Z
IMAGE1 S H3-LINK	KARL STORZ	TC300
Monitor	NDS surgical imaging, LLC	N-90X0568-G
Optical Cable	ShenDa	U8724
Scissors	ShenDa	X5261A
Sealing Cap	ShenDa	T7303
Uterine Balloon Dilator	ShenDa	U9522 DG-1
XENON NOVA 300	KARL STORZ	201340 20