Hysteroscopic Myomectomy

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Hysteroscopic resection of myomas (hysteroscopic myomectomy)

Submucous and intracavitary myomas can often be removed through the cervix using an instrument called a resectoscope. The resectoscope is a special type of hysteroscope with a built in wire loop that uses high-frequency electrical energy to cut or coagulate tissue. It was developed for surgery of the bladder and the male prostate over fifty years ago to allow surgery inside an organ without having to make an incision, and has made hysteroscopic myomectomy possible.

How is hysteroscopic resection of myomas done?

Resectoscope used for hysteroscopic myomectomy

Just as with a standard hysteroscope, the resectoscope is inserted through the cervix. Because it goes through the cervix, it is not necessary to make an incision. Procedures using the resectoscope are done in an operating room setting, such as in an outpatient surgery center. This can at times be done under local anesthesia, but most women prefer to be completely asleep with general anesthesia.

The resectoscope is far more efficient at removing tissue (such as fibroids or large polyps) than conventional instruments. Because of this, the resectoscope should be used only by physicians who have training in its use and who use it on a regular basis.

View through the resectoscope of actual removal of fibroid

Hysteroscopic resection of myoma:  large fibroid in uterine cavity
We are looking in the uterus through a resectoscope. We can see a large fibroid filling the uterine cavity. The cutting loop of the resectoscope has been placed beyond the fibroid, and is getting ready to cut out a piece of fibroid. The pieces are removed through the cervix.
Fibroid has been completely removed, and a normal uterine cavity can be seen.
The fibroid has been entirely removed. The uterine cavity, which had been hidden by the fibroid, can now be seen. (The loop looks larger in this photo because it is closer to the lens.)

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The medical information presented in this website represents the opinion of Dr. Indman, and is based on his knowledge and experience. It is not applicable to all patients or physicians. Anyone visiting this or other related medical sites should discuss symptoms, findings, and alternatives with their personal gynecologist.