Hysteroscopic Resection of Uterine Septum: An Updated Approach

Abstract

<h3>Study Objective</h3> Demonstrate an updated technique for hysteroscopic resection of uterine septum. <h3>Design</h3> Case Study–Surgical Technique. <h3>Setting</h3> Major academic medical center. <h3>Patients or Participants</h3> Patient with known uterine septum undergoing hysteroscopic resection of septum with concomitant indicated laparoscopy. <h3>Interventions</h3> Operative hysteroscopy with resection of septum, with laparoscopic assistance. <h3>Measurements and Main Results</h3> The purpose of this video is to demonstrate the combined technique of traditional hysteroscopic scissors with an advanced hysteroscopic tissue removal system to optimally remove the avascular septal tissue and restore normal uterine cavity architecture. The patient later underwent a successful intrauterine device insertion with sonographic guidance, demonstrating a normal uterine cavity and fully resected septum. <h3>Conclusion</h3> Use of an advanced hysteroscopic tissue removal system in combination with traditional incision of the uterine septum results in optimal anatomic cavity restoration. This technique can be used alone or in combination with indicated laparoscopy, which provides additional visual confirmation of adequate resection using a "jack-o-lantern" technique. Further prospective studies should be conducted to evaluate the impact of this updated technique on gynecologic (i.e., bleeding) and obstetric outcomes.