Laser Hysterofiberscopic Intrauterine Surgery Guided by Laparoscopically Assisted Intra-Abdominal Sonohysterography: A Retrospective Review of 65 Patients

Abstract

Abstract

Background: Although surgical procedures involving resectoscopes are widely used to treat intrauterine lesions, various complications related to these procedures have been reported. To avoid such complications, the current authors have been performing laser hysterofiberscopic intrauterine surgery guided by laparoscopically assisted intra-abdominal sonohysterography (LHIS-GLAIS). Objective: This retrospective review was conducted to assess the effectiveness of LHIS-GLAIS and its related complications. Materials and Methods: A total of 65 patients with intrauterine lesions that required hysteroscopic surgery between 1997 and 2008 were investigated. These patients underwent LHIS-GLAIS after their informed consent was obtained. The amount of bleeding, if the surgery was completed successfully, if complications developed, and if the surgery was converted to laparotomy were retrospectively examined. Results: There were 4 patients with Asherman's syndrome, 11 patients with uterine malformations, and 50 patients with submucosal myomas. While surgery for all patients with Asherman's syndrome or uterine malformations was completed successfully, there were 6 patients with submucosal myoma (6/65; 9.2%) in whom the myomas remained. Complications were not observed in any patients with Asherman's syndrome or uterine malformations. There were 6 patients who had submucosal myomas with complications (6/65; 9.2%). One patient with uterine perforation was the only patient whose procedure was converted to laparotomy (1/65; 1.5%). Conclusions: LHIS-GLAIS appears to be particularly effective for patients with Asherman's syndrome and uterine malformations. In addition, although this procedure was effective for addressing submucosal myomas, complications were observed in some patients. (J GYNECOL SURG 30:280)