Ultrasound Guidance during Hysteroscopy

Common complications of HM are uterine perforation, incomplete removal of fibroid bleeding, postoperative adhesion and electrolyte imbalance. Complete resection of fibroids in HM depends upon surgical skill and experience. It’s not possible to recognise the margins of the fibroid by hysteroscopy. Incomplete removal is more common in G2 fibroids [6]. Several studies showed that incomplete resection rates ranges from 5 to 17 percent [6,7]. Several techniques described for HM. Resectoscopic slicing is the gold standard technique for G0 fibroids [8]. This technique has excellent results in G0 fibroids. There is no gold standard technique regarding hysteroscopic excision of sub mucous fibroids with a major intramural component (G1 and G2 fibroids). Several surgical techniques described for avoid from complications forremoval of G1 and G2 fibroids. Resectoscopic slicing is the classic technique for HM. Two-step procedure first described by Donnez et al. [9] represents an effective technique which includes combination of hormonal treatment and hysteroscopic laser surgery [9]. Main problem of this procedure is this method requires two surgical interventions. This procedure also expensive too. Cold loop technique allows total excision of fibroid in one step but needs experienced surgeon [10]. This could be a disadvantage for the beginner medical stuff. Ultrasound guidance during gynecological surgery may prove safety and accuracy of the procedure [11]. Also continuous visualisation can shorten the operation time. Obesity and a scarred abdomen (eg, after cesarean deliveries) may diminish transabdominal image quality.