Author, Year | Study Design | Objective | N | Summary | Conclusions | Limitations |
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). | 311a
| 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. | 315 | 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. |
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