Facts, Views & Vision
in ObGyn

Journal of the European Society for Gynaecological Endoscopy

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European Society for Gynaecological Endoscopy (ESGE) Good Practice Recommendations on surgical techniques for Removal of Fibroids: Part 2 Hysteroscopic Myomectomy

T.J. Clark1, L. Antoun1, A. Di Spiezio Sardo2, V. Tanos3, J. Huirne4, E.W. Bousma5, T.Smith-Walker6, E. Saridogan7

On behalf of the European Society for Gynaecological Endoscopy Uterine Fibroids Working Group

1 Birmingham Women’s & Children’s Hospital, University of Birmingham, United Kingdom
2 Obstetrics and Gynaecology Department, Università degli Studi di Napoli “Federico II”, Italy
3 Department of Basic and Clinical Science, University of Nicosia Medical School and Aretaeio Hospital, Cyprus
4 Department of Obstetrics & Gynecology, St. Antonius Hospital, The Netherlands
5 Department of Obstetrics & Gynaecology, Amsterdam University Medical Center and Amsterdam Reproduction and Development Research Institute, The Netherlands
6 Gynaecology Department, Royal Cornwall Hospital, United Kingdom
7 Elizabeth Garrett Anderson Institute for Women’s Health, University College London and University College London Hospital, United Kingdom.


Published online: Dec 18 2024

https://doi.org/10.52054/FVVO.16.4.054

Abstract

Submucosal uterine fibroids are the rarest type of fibroids. They can lead to abnormal uterine bleeding and may play a role in infertility and miscarriage. Hysteroscopic myomectomy is the preferred treatment to relieve bleeding caused by these fibroids and to restore the normal structure of the uterine cavity. The European Society for Gynaecological Endoscopy Uterine Fibroids Working Group developed recommendations based on the best available evidence and expert opinion for the surgical treatment of uterine fibroids. In this second part of the recommendations, hysteroscopic approaches are described. This review explores the techniques related to hysteroscopic myomectomy, focusing on narrower scopes, fluid management and advances in tissue removal systems and electrosurgery.