Hysteroscopy pp 635-648 | Cite as

The Shaver Technique for Operative Hysteroscopy

  • Giuseppe Bigatti


Presently, the double flow bipolar resectoscope is considered the gold standard technique to perform hysteroscopic operations. We have recently proposed an alternative approach to operative hysteroscopy called Intrauterine Bigatti Shaver (IBS®) that, by removing the tissue chips at the same time as their resection, improves visualization during the procedure, reducing several problems of conventional resectoscopy such as fluid overload, water intoxication, uterine perforation, and long surgeon’s learning curve. In cooperation with Karl Storz GmbH & Co., we have created a new shaving system that, when introduced through the straight operative channel of a panoramic 90° optic, allows performance of all major hysteroscopic operations. This study is a review of the present literature regarding the shaver technique including its history and its future indications


IBS® Intrauterine Bigatti Shaver Operative hysteroscopy 



This chapter is dedicated to Ralph Sandler and to all the men of the Rollerball Team. Special thanks go to Karl Storz GmbH & Co employees, Storz Italia for their technical support, and in particular, to Dr. H.C. Mult. Sybill Storz and Helmut Wehrstein, who believed in this project from its beginning. Special thanks are addressed to Prof. Ivo Brosens, Dr. Rudi Campo, Dr. Yves Van Belle, and Prof. Berndt Rudelstorfer, maestro di vita. From my team I must thank Dr. Maddalena Santirocco for the research and iconographic part of this study, and the nurse Chiara Molaschi for her loyalty and support during the surgical operations performed all over the world. Translation by Ettore Claudio Iannelli. Declaration of interest: The contracts with Dr. Bigatti and the mutually provided benefits concerning the development and the consultancy on the IBS® are in no way affiliated with any other service or procurement decisions on the part of the contractual parties, including studies like the present one. Therefore, Dr. Bigatti has received no financial compensation for this study.


  1. 1.
    Bigatti G. IBS® Integrated Bigatti Shaver, an alternative approach to operative hysteroscopy. Gynecol Surg. 2011;8(2):187.CrossRefGoogle Scholar
  2. 2.
    Associazione Italiana di Endourologia-Da Lichtleiter ai Nostri Giorni-Segreteria Via Porrettana 76/2-40033-Casalecchio di Reno (Bo)
  3. 3.
    Di Spezio Sardo A, Mazzon I, Bramante S, Bettocchi S, Bifulco G, Guida M, Nappi C. Hysteroscopic myomectomy: a comprehensive review of surgical techniques. Hum Reprod Update. 2008;14(2):101–19.CrossRefGoogle Scholar
  4. 4.
    Witz CA, Silverberg KM, Burns WN, Schenken RS, Olive DL. Complications associated with absorption of hysteroscopic fluid media. Fertil Steril. 1993;60(5):745–56.CrossRefPubMedGoogle Scholar
  5. 5.
    Shaafer M, Von Ungern-Sternberg BS, Wight E, Schneider MC. Isotonic fluid absorption during Hysteroscopy resulting in severe hyperchloremic acidosis. Anesthesiology. 2005;103:203–4.CrossRefGoogle Scholar
  6. 6.
    Van Kruchten PM, Vermelis JM, Herold I, Van Zundert AA. Hypotonic and isotonic fluid overload as a complication of hysteroscopic procedures: two case reports. Minerva Anestesiol. 2010;76(5):373–7.PubMedGoogle Scholar
  7. 7.
    Pasini A, Belloni C. Intraoperative complications of 697 consecutive operative hysteroscopies. Minerva Ginecol. 2001;53(1):13–20.PubMedGoogle Scholar
  8. 8.
    Jansen FW, Vredevoogd CB, Van Ulzen K, Hermans J, Trimbos JB, Trimbos-Kemper TC. Complication of hysteroscopy: a prospective, multicenter study. Obstet Gynecol. 2000;96(2):266–70.PubMedGoogle Scholar
  9. 9.
    Emanuel MH, Wamsteker K. The intrauterine morcellator: a new hysteroscopic operating technique to remove intrauterine polyps and myomas. J Minim Invasive Gynecol. 2005;12(1):65–6.CrossRefGoogle Scholar
  10. 10.
    Bigatti G, Ferrario C, Rosales M, Baglioni A, Bianchi S. IBS® Integrated Bigatti Shaver versus conventional bipolar resectoscope: a randomised comparative study. Gynecol Surg. 2012;9(1):63–72.CrossRefGoogle Scholar
  11. 11.
    Emanuel MH, Hart A, Wamsteker K, Lammes F. An analysis of fluid loss during transcervical resection of submucous myomas. Fertil Steril. 1997;68(5):881–6.CrossRefPubMedGoogle Scholar
  12. 12.
    Van Dongen H, et al. Hysteroscopic morcellator for removal of intrauterine polyps and myomas: a randomized controlled pilot study among residents in training. J Minim Invasive Gynecol. 2008;15:466–71.CrossRefPubMedGoogle Scholar
  13. 13.
    Deans R, Abbott J. Review of intrauterine adhesions. J Minim Invasive Gynecol. 2010;17(5):555–69.CrossRefPubMedGoogle Scholar
  14. 14.
    Campo R, Molinas CR, Rombauts L, Mestdagh G, Lauwers M, Braekmans P, Brosens I, Van Belle Y, Gordts S. Prospective multicentre randomized controlled trial to evaluate factors influencing the success rate of office diagnostic hysteroscopy. Hum Reprod. 2005;20(1):258–63.CrossRefPubMedGoogle Scholar
  15. 15.
    Bigatti G, Franchetti S, Rosales M, Baglioni A, Bianchi S. Hysteroscopic myomectomy with the IBS® Integrated Bigatti Shaver versus conventional bipolar resectoscope: a retrospective comparative study. Gynecol Surg. 2014;11:9–18.CrossRefGoogle Scholar
  16. 16.
    Bigatti G, Ferrario C, Rosales M, Baglioni A, Bianchi S. A 4-cm G2 cervical submucosal myoma removed with the IBS® Integrated Bigatti Shaver. Gynecol Surg. 2012;9:453–6.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Kurman RJ. Anatomy and histology of the uterine corpus – Blaustein’s pathology of the female genital tract. 4th ed. New York, NY: Springer; 1994. p. 327–66.Google Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Div. di Ginecologia ed OstetriciaOspedale Centrale di Bolzano Azienda Sanitaria dell’Alto AdigeBolzanoItaly

Personalised recommendations