Comparison of Resection Rates Using 3 Different Hysteroscopic Devices on a Simulation Model for Myomectomy of Calcified Fibroids

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Journal of Minimally Invasive Gynecology


Study Objective: To evaluate and compare the tissue resection rates of 3 different hysteroscopic tissue removal devices using a simulation model of dense fibroid tissue in a uterine model. Design: A 3-arm Bench Study. Setting: Simulation lab. Patients or Participants: Experienced hysteroscopic surgeons. Interventions: 24 surgeons were exposed to 3 identical validated uterine and tissue simulation models and given 5 minutes to resect a new “calcified fibroid” with each of the 3 devices (a disposable, single use 4.6mm diameter resectoscopic system, a 7.25mm rigid resectoscopic system, and a 9mm rigid resectoscopic system) in accordance with FDA approved Instructions for Use. The order of the devices was randomized to reduce experience bias with the model. None of the 24 physicians were considered new users of the rigid resectoscopes; however, 70.8% were first-time single-use resectoscope users. Measurements and Main Results: Comparing the rate of tissue resected, faster rates were achieved with the 4.6mm single-use resectoscope (0.51g/min) as compared to the 7.25mm (0.24g/min) or 9mm reusable devices (0.29g/min) achieving statistical significance (p=0.000 and p=0.000, respectively). Among the first-time users of the 4.6mm resectoscope, faster rates were noted (0.44g/min) when compared to the experienced users with the other devices, while experienced 4.6mm resectoscope users had resection rates of 0.70g/min. Conclusion: Using a novel calcified fibroid hysteroscopic myomectomy simulation model, we showed that the single-use, 4.6mm resectoscopic system compares favorably to the larger diameter rigid resctoscopic systems with respect to rates of resection, even among first time users. In addition, this model shows great promise for simulation training of hysteroscopic myomectomy skills.




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52nd AAGL American Association of Gynecologic Laparoscopists Global Congress on Minimally Invasive Gynecology, November 5-8, 2023, Nashville, TN