Hysteroscopic morcellator versus hysteroscopic scissors for endometrial polypectomy: a retrospective study

Authors

  • Ka Lok Ma United Christian Hospital
  • Pui Ying Wong
  • Po Ming Yu
  • Chun Hung Yu

DOI:

https://doi.org/10.12809/hkjgom.24.1.360

Keywords:

Endometrial neoplasms, Hysteroscopy

Abstract

Objective: To compare hysteroscopic morcellation with hysteroscopic scissors for endometrial polypectomy in terms of operating time, the need for cervical dilatation, blood loss, complications, and completeness of removal.
Methods: Medical records of patients who underwent hysteroscopic polypectomy using either the Intrauterine BIGATTI Shaver (IBS) system or hysteroscopic scissors between January 2020 and August 2022 at the United Christian Hospital or Tseung Kwan O Hospital were retrospectively reviewed.
Results: A total of 1063 women were operated on using the IBS (n=132) or hysteroscopic scissors (n=931). More patients in the IBS group required general/spinal anaesthesia (97.7% vs 71.1%, p<0.001) and cervical dilatation (77.3% vs 30.1%, p<0.001). The operating time was shorter in the IBS group when removing one polyp (18.6 vs 20.0 min, p=0.049) and when performed by trainees independently (17.9 vs 19.8 min, p=0.007) but was longer when performed by specialists (22.7 vs 19.7 min, p<0.001). All patients in the IBS group achieved complete removal of polyps, compared with five patients with incomplete removal of polyps in the scissors group.
Conclusion: Compared with hysteroscopic scissors, hysteroscopic morcellation requires less operating time when removing one polyp and when performed by trainees independently and is more effective in achieving complete removal, but the need for cervical dilatation and anaesthesia is more for hysteroscopic morcellation.

References

Lieng M, Istre O, Qvigstad E. Treatment of endometrial polyps: a systematic review. J Minim Invasive Gynecol 2010;17:S4-S5.

The use of hysteroscopy for the diagnosis and treatment of intrauterine pathology: ACOG Committee Opinion Summary, Number 800. Obstet Gynecol 2020;135:754-6.

Cohen S, Greenberg JA. Hysteroscopic morcellation for treating intrauterine pathology. Rev Obstet Gynecol 2011;4:73-80.

Bigatti G, Ferrario C, Rosales M, Baglioni A, Bianchi S. A 4-cm G2 cervical submucosal myoma removed with the IBS® Integrated Bigatti Shaver. Gynecol Surg 2012;9:453-6.

Ren F, Huang G, Wang X, Li X, Cai J. Comparison of hysteroscopic morcellation versus resectoscopy in treatment of patients with endometrial lesions: a meta-analysis. Med Sci Monit 2022;28:e936771.

Pampalona JR, Bastos MD, Moreno GM, et al. A comparison of hysteroscopic mechanical tissue removal with bipolar electrical resection for the management of endometrial polyps in an ambulatory care setting: preliminary results. J Minim Invasive Gynecol 2015;22:439-45.

Smith PP, Middleton LJ, Connor M, Clark TJ. Hysteroscopic morcellation compared with electrical resection of endometrial polyps: a randomized controlled trial. Obstet Gynecol 2014;123:745-51.

Stoll F, Lecointre L, Meyer N, et al. Randomized study comparing a reusable morcellator with a resectoscope in the hysteroscopic treatment of uterine polyps: The RESMO study. J Minim Invasive Gynecol 2021;28:801-10.

Bigatti G, Ferrario C, Rosales M, et al. IBS® Integrated Bigatti Shaver versus conventional bipolar resectoscopy: a randomised comparative study. Gynecol Surg 2012;9:63-72.

Hamerlynck TW, Schoot BC, van Vliet HA, Weyers S. Removal of endometrial polyps: hysteroscopic morcellation versus bipolar resectoscopy, a randomized trial. J Minim Invasive Gynecol 2015;22:1237-43.

Lopez-Carral JM, Novo AF, Iglesias AF, Martin-Lancharro P. Hysteroscopic endometrial polypectomy: comparative retrospective study of the morcellator system versus electrosurgical resection. Rep Gynecol Surg 2019;2:22-6.

Li C, Dai Z, Gong Y, Xie B, Wang B. A systematic review and meta-analysis of randomized controlled trials comparing hysteroscopic morcellation with resectoscopy for patients with endometrial lesions. Int J Gynecol Obstet 2017;136:6-12.

Lyubenov AD, Tomov ST, Kiprova DK, Gorchev GA, Tsvetanova KT. A comparative study of hysteroscopic morcellation or resection of uterine polyps. J Biomed Clin Res 2019;12:27-32.

Gururaj R. A review on the use of hysteroscopy tissue removal system in gynaecology. Obstet Gynecol Open Acc 2021;5:142.

Shazly SA, Laughlin-Tommaso SK, Breitkopf DM, et al. Hysteroscopic morcellation versus resection for the treatment of uterine cavitary lesions: a systematic review and meta-analysis. J Minim Invasive Gynecol 2016;23:867-77.

Yin X, Cheng J, Ansari SH, et al. Hysteroscopic tissue removal systems for the treatment of intrauterine pathology: a systematic review and meta-analysis. Facts Views Vis Obgyn 2018;10:207-13.

Tsuchiya A, Komatsu Y, Matsuyama R, Tsuchiya H, Takemura Y, Nishii O. Intraoperative and postoperative clinical evaluation of the hysteroscopic morcellator system for endometrial polypectomy: a prospective, randomized, single-blind, parallel group comparison study. Gynecol Minimally Invasive Ther 2018;7:16-21.

Hamerlynck TW, Dietz V, Schoot BC. Clinical implementation of the hysteroscopic morcellator for removal of intrauterine myomas and polyps. A retrospective descriptive study. Gynecol Surg 2010;8:193-6.

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Published

2024-02-06

How to Cite

1.
Ma KL, Wong PY, Yu PM, Yu CH. Hysteroscopic morcellator versus hysteroscopic scissors for endometrial polypectomy: a retrospective study. Hong Kong J Gynaecol Obstet Midwifery [Internet]. 2024 Feb. 6 [cited 2024 Dec. 4];24(1). Available from: https://hkjgom.org/home/article/view/360

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Original Article (Gynaecology)