3 The procedure

3 The procedure

3.1 Hysteroscopic morcellation aims to remove uterine leiomyomas (fibroids) during a single insertion of a hysteroscope into the uterus. This contrasts with traditional hysteroscopic resection of leiomyomas, 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.

3.2 Hysteroscopic morcellation of uterine leiomyomas 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 leiomyoma tissue. The aspirated tissue can be collected for histological analysis.

3.3 Different devices are available for this procedure.

  • National Institute for Health and Care Excellence (NICE)