Hysteroscopic morcellation of uterine fibroids

Hysteroscopic morcellation aims to remove uterine fibroids during a single insertion of a hysteroscope into the uterus

• contrasts with traditional hysteroscopic resection of fibroids, in which the instrument is reinserted into the uterus multiple times
• hysteroscopic morcellation is intended to reduce the risk of traumatic injury to the uterus and the risk of inadvertent fluid overload associated with traditional procedures (because the procedure may be completed more rapidly)
  • an intended advantage of the procedure over thermal ablation techniques is avoiding the risk of thermal injury
  • contrary to some other alternative techniques that use heat, coagulation or vaporization, the morcellation by IUM represents a new alternative technique which preserves tissue for histological examination.

Hysteroscopic morcellation of uterine fibroids is usually done with the patient under general or spinal anaesthesia, typically as a day-case procedure

• a hysteroscope is inserted into the uterus through the cervix and saline is pumped through a small channel in the hysteroscope to distend the uterus
• a specially designed morcellator is introduced via the hysteroscope and used to cut and simultaneously aspirate the fibroid tissue
• aspirated tissue can be collected for histological analysis.

Reference:

• (1) NICE (April 2014). Hysteroscopic morcellation of uterine fibroids