Breaking the Limits on Office Hysteroscopy Myomectomy
Until recently, the only option for treating submucous myomas was to perform a resectoscopy in the operating room under anesthesia. In the last decade, the development of new devices/energy sources and the implementation of new techniques have led to a myomectomy technique without anesthesia. The consequence is that we are able to perform a larger number of procedures in the office. We analyzed the different office myomectomy technique with the limits. The limitation for all the techniques are based on the myoma’s size, type, and especially the space in cavity defined as the container/content ratio. Preservation of the integrity of the pseudocapsule for avoiding myometrium injuries is crucial in any procedure. The way to break the limits of myomectomy in office setting is to improve the ratio by reducing the fibroid volume by medical treatment or by surgical techniques adapted also to office. Finally, we present a new option for myolysis performed in office with diode laser, proving the feasibility and the results.
KeywordsOffice hysteroscopy Submucous myoma Diode laser Laser myolysis Myomectomy
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