Pakrashi, 2013

Case Report

To describe a case of complete enucleation of a Type II leiomyoma using the hysteroscopic morcellator (HM)

1

Removal of two submucosal leiomyomas (Type I 2.9 cm and Type II 1.9 cm) in a 41 y/o P0 female with infertility and symptomatic uterine fibroids

THM can act as a hook allowing for complete removal of submucous fibroids

No post-operative follow up imaging

Simons, 2011

Case Report

To describe whether the hysteroscopic morcellator (HM) can be used as an alternative device for uterine septum removal

1

Successful removal of a uterine septum in a 34 yo woman with recurrent miscarriages and history of bicornuate uterus.

HM is safe (no complications, EBL <100 cc), efficient (23 minute procedure time), and effective (follow up MRI at 10 weeks post-op revealed no signs of septum) alternative for uterine septum

None

Hamerlynck, 2011

Case Series

To evaluate the feasibility, effectiveness and safety for removal of intrauterine lesions using a small diameter hysteroscopic morcellator (HM)

23

Operative details of HM in women (age 28 - 76 yo) who underwent HM for various uterine pathology, including endometrial polyp (n = 15), submucous fibroid (n = 5), retained placenta (n = 2), and thickened endometrial lining (1).

HM is a safe (median fluid loss 210) and efficient (mean operating time 6 minutes) alternative to conventional resectoscopy (no conversion to conventional method)

No direct comparison to conventional resectoscopy

AlHilli, 2011

Retrospective cohort review

To compare recurrence rates and factors associated with recurrence of endometrial polyps (EP) following operative hysteroscopy (OH) and hysteroscopic morcellation (HM).

311^a

Operative details of HM in women with endometrial polyps were compared between OH and HM. A total of 59 patients had a recurrence, the majority of which occurred 5 years post-operatively (29%).

Recurrence of EP is independent of the method of removal (OH vs. IM, p = 0.40). Risk factors for recurrence included younger age and being premenopausal.

None

Lanzani, 2011

Prospective descriptive

To evaluate the feasibility of office hysteroscopy in the treatment of endometrial polyps larger than 15 mm with a “two-step” removal using the intrauterine morcellating device.

59

The “two-step” office polyp removal included an initial histologic sampling at the base of polyp and deep incision of the pedicle without removal of the lesion followed by removal after 2 months. This approach was performed in a postmenopausal cohort with a median age of 58.37.

A “two step” office confers lower cost, and is a safe (no severe complications reported) and efficient (median time of procedure 8.25 minutes) alternative to conventional resectoscopy in postmenopausal women.

No definition for severe complications or direct comparison to conventional resectoscopy.

Hamerlync, 2011

Retrospective descriptive

To report the experience with a novel technique, the hysteroscopic morcellator (HM), for removal of intrauterine fibroids and endometrial polyps.

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Operative details of HM in women with endometrial polyps (n = 278) and fibroids (n = 37) were assessed. The mean diameter for intrauterine fibroids was 2.0 cm (Type 0, n = 23; Type 1, n = 11; Type 2, n = 3)

The HM is a safe (mean fluid deficit for fibroids 440cc, for polyps, 40cc) and efficient (mean operating time 18.2 minutes for fibroids, and 6, 6 minutes for polyps) alternative to conventional resectoscopy. However, 3 conversions to conventional resectoscopy were needed in the fibroid cohort, and they recommended against its use in Type 2 fibroids.