A Modified Technique of Bipolar Loop Resectoscopic Slicing for Treating Submucous Fibroids With Enucleation Makes the Operation Safer.

Wenying Zhang,Yu Liu,Chunchun Wang,Jing Liu,Qiongwei Wu,Chengbin Ma

doi:10.3389/fsurg.2021.746936

Wenying Zhang, Yu Liu + Show 4 more

Open Access

https://doi.org/10.3389/fsurg.2021.746936

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Abstract

Background: In this study, a modified technique of resectoscopic slicing with a common bipolar loop was introduced, which facilitated the complete removal of the submucous fibroid inside the uterine cavity without any novel equipment.Results: Compared with the classical technique, our modified procedure possessed a shorter operation time (22.9 ± 7.3 vs. 38.9 ± 13.0 min, p < 0.05) and a smaller distending media volume (1,495.6 ± 540.1 vs. 2,393.1 ± 719.4 ml, p < 0.01).Conclusion: As a result, the current study suggested that the enucleation of submucous fibroid under hysteroscopy could be achieved by using only the bipolar loop, which reduced the consumption for novel equipment and enhanced the safety of the technique.

Highlights

Uterine fibroids are the most common benign tumor found in the female genital tract
The “cold loop” myomectomy was first reported by Mazzon in 1995, which was characterized by a sequence of three different operating steps: (i) excision of the intracavitary component of the fibroid, (ii) enucleation of the intramural component of the fibroid using a special cold loop, and (iii) the “neoformation” is completely and safely excised using a cutting loop
Submucous fibroid in the uterus is a common clinical disease, accounting for 5.5–10% of uterine fibroid

Summary

Introduction

Uterine fibroids are the most common benign tumor found in the female genital tract. Localization of uterine fibroids seems to be an important factor in determining the severity of symptomatology. Many techniques for hysteroscopic myomectomy of submucous fibroid, such as cold loop technique [4, 5] and Litta’s enucleation “in toto” technique [6], have been described and aimed to completely excise fibroid by one-step procedure and avoid both short-term and long-term complications. The “cold loop” myomectomy was first reported by Mazzon in 1995, which was characterized by a sequence of three different operating steps: (i) excision of the intracavitary component of the fibroid, (ii) enucleation of the intramural component of the fibroid using a special cold loop, and (iii) the “neoformation” is completely and safely excised using a cutting loop. The Litta’s enucleation “in toto” technique is a one-step hysteroscopic myomectomy. A modified technique of resectoscopic slicing with a common bipolar loop was introduced, which facilitated the complete removal of the submucous fibroid inside the uterine cavity without any novel equipment

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