Intraoperative ultrasound guidance for operative hysteroscopy - A prospective study

To evaluate the efficacy and safety of ultrasound (US) guidance as compared to laparoscopic monitoring during operative hysteroscopy. STUDY DESIGN: Prospective, open study including 81 patients undergoing oper ative hysteroscopy under US guidance for uterine septum and submucous myoma . Clinical and surgical outcomes were compared with those in an historical control group Of 45 patients undergoing the same operation under laparoscop ic guidance. RESULTS: US guidance proved satisfactory in all patients, and there were no complications due to insufficient visualization of the pelvic structures; in Mo case was conversion to laparoscopic guidance required. US scanning wa s most useful in determining the outer limit of the intramural component of submucous partial intramural myoma, allowing complete resection. During me troplasty, US guidance allowed extension oft he resection beyond the normal limit conventionally defined by hysteroscopy; none required reintervention . By comparison, in the control group, a second attempt was required becaus e the operation was insufficiently radical in four patients. CONCLUSION: US guidance was used successfully as the only visual aid for hy steroscopic surgery, comparing favorably with laparoscopy in terms of effic acy and safety.