Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Sep;13(3):193-201.
doi: 10.52054/FVVO.13.3.026. Epub 2021 Jun 10.

Mechanical hysteroscopic tissue removal or hysteroscopic morcellator: understanding the past to predict the future. A narrative review

M Franchini, O Ceci, P Casadio, J Carugno, G Giarrè, G Gubbini, U Catena, M Chiara de Angelis, A Di Spiezio Sardo

Mechanical hysteroscopic tissue removal or hysteroscopic morcellator: understanding the past to predict the future. A narrative review

M Franchini et al. Facts Views Vis Obgyn. 2021 Sep.

Abstract

Background: In recent years, the available evidence revealed that mechanical hysteroscopic tissue removal (mHTR) systems represent a safe and effective alternative to conventional operative resectoscopic hysteroscopy to treat a diverse spectrum of intrauterine pathology including endometrial polyps, uterine myomas, removal of placental remnants and to perform targeted endometrial biopsy under direct visualisation. This innovative technology simultaneously cuts and removes the tissue, allowing one to perform the procedure in a safer, faster and more effective way compared to conventional resectoscopic surgery.

Objective: To review currently available scientific evidence concerning the use of mechanical hysteroscopic morcellators and highlight relevant aspects of the technology.

Material and methods: A narrative review was conducted analysing the available literature regarding hysteroscopic tissue removal systems.

Main outcome measures: Characteristics of available mHTR systems, procedures they are used for, their performance including safety aspects and their comparison.

Results: A total of 7 hysteroscopic morcellators were identified. The diameter of the external sheet ranged from 5.25 to 9.0 mm, optics ranged from 0.8 to 6.3 mm with 0o angle. The cutter device diameter ranged from 2.9 to 4.5 mm most of them with rotation and reciprocation.

Conclusion: We conclude that the adoption of mHTR has shown to reduce operating time, simultaneously cutting and suctioning tissue fragments avoiding the need for multiple removal and reinsertions of the device into the uterine cavity as well as reducing the volume of distension media required to complete the procedure compared to using the hysteroscopic resectoscope.

PubMed Disclaimer

Figures

Figure 1
Figure 1
— Different uses of mechanical hysteroscopic tissue removal systems: A. endometrial polyp removal, B. myomectomy, C. removal of placental remnants, D. targeted endometrial biopsy.
See this image and copyright information in PMC

References

    1. AlHilli MM, Nixon KE, Hopkins MR, et al. Long-term outcomes after intrauterine morcellation vs hysteroscopic resection of endometrial polyps. J Minim Invasive Gynecol. 2013;20:215–221. - PubMed
    1. Ansari SH, Bigatti G, Aghssa MM. Operative hysteroscopy with the Bigatti shaver (IBS ® ) for the removal of placental remnants. Facts Views Vis Obgyn. 2018;10:153–159. - PMC - PubMed
    1. Arnold A, Ketheeswaran A, Bhatti M, et al. A prospective analysis of hysteroscopic morcellation in the management of intrauterine pathologies. J Minim Invasive Gynecol. 2016;23:435–441. - PubMed
    1. Bettocchi S, Ceci O, Nappi L, et al. Operative office hysteroscopy without anaesthesia: analysis of 4863 cases performed with mechanical instruments. J Am Assoc Gynecol Laparosc. 2004;11:59–61. - PubMed
    1. Bigatti G, Franchetti S, Rosales M, et al. Hysteroscopic myomectomy with the IBS ® Integrated Bigatti Shaver versus conventional bipolar resectoscope: a retrospective comparative study. Gynecol Surg. 2014;11:9–18.

LinkOut - more resources