The use of the 19Fr. Intrauterine BIGATTI Shaver in operative hysteroscopy for benign intracavitary lesions: A feasibility study

Abstract

Background

Treatment of common benign intracavitary lesions of the uterus, such as endometrial polyps, submucosal myomas, and retained products of conception (RPOC) has evolved significantly over the past decades. Hysteroscopic tissue removal (morcellation) was introduced as an alternative to the traditional operative hysteroscopy with bipolar resectoscopic excision, due to concerns regarding thermal damage and impaired visibility. Recently, with the aim of promoting a minimally invasive approach and the possibility of use in an office setting, smaller diameter hysteroscopic tissue removal systems were designed, such as the reusable 19 Fr. Intrauterine BIGATTI Shaver (IBS®). This prospective study aims to assess the feasibility and outcomes of using the 19 Fr. Intrauterine BIGATTI Shaver (IBS®) for benign intracavitary lesions.

Methods

We performed a multicentric prospective cohort study among patients with suspected benign intracavitary lesions. Procedures were performed using the 19 Fr. BIGATTI Shaver under sedation or general anaesthesia. Data on procedure characteristics and complications were collected prospectively.

Results

Fifty-eight patients were included, of which the majority had endometrial polyps. Complete resection was achieved in all cases, with only in 5 % need for additional techniques after hysteroscopic tissue removal during the same intervention. Operator satisfaction was generally high, particularly for endometrial polyps. However, challenges were encountered with RPOC, including 2 cases of excessive bleeding and longer tissue removal times (2 min for endometrial polyps vs 4.5 for RPOC). Postoperative complications were rare (2 %).

Conclusion

This study demonstrates the feasibility and safety of using the 19 Fr. IBS® for benign intracavitary lesions, particularly for endometrial polyps. Further research is warranted to validate the device’s utility in broader clinical contexts and to address specific challenges associated with different lesion types.