Morcellator Versus Resectoscope in the Treatment of Uterine Polyps by Hysteroscopy

NCT02472197 | Completed

• 1 other identifier: 6043
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

Intrauterine pathologies are currently treated by hysteroscopic resection. In this surgical procedure, the intrauterine pathology is resected by a transcervical approach in several fragments using a mono or bipolar cove after distension of the uterine cavity and by endoscopic control. The main risks of this surgery are: uterine perforation and OHIA (operative hysteroscopy intravascular absorption) syndrome. Hysteroscopic morcellators are new intrauterine devices, recently appeared on the French market. In comparison to classical resectors, morcellators have several theoretical advantages:

• A smaller instrument diameter with potentially a lower risk of uterine perforation and cervical laceration during the dilatation procedure,
• The use of physiological serum, eliminating the risk of neurological toxicity of glycine,
• The risk of electrical accident is canceled (internal or external burns due to leakage current),
• A decreased risk of air embolism, due to the absence of bubbles' production,
• The instrument is always under visual control, the perforation risk by the active instrument is therefore very limited,
• The vision is not obscured by the fragments or by the bubbles,
• The treatment of pre-ostial pathologies, not always easy in classical resections, could be facilitated,
• the absence of thermal effect, and therefore a potentially lower endometrial aggression, is interesting in women with reproductive desire,
• Absence of chips management, limiting the entry and exit movements in the uterine cavity, improving the vision, reducing the infectious and traumatic risks, specially uterine perforation and air embolism,
• Morcellation could preserve tissues for histological analysis of possible malignancy (compared to techniques using heat, coagulation, vaporization),
• Easy learning in comparison to the time-consuming learning of classical hysteroscopic resection,
• Generated additional cost could be partly amortized by reducing operating time and complications. It seemed useful to study this new technology. The primary purpose was to compare the time of hysteroscopic treatment of uterine polyps between a hysteroscopic morcellator the UNIDRIVE S III / DrillCut-X II-GYN-Shaver (Integrated Bigatti Shaver IBS), Storz®, and a conventional resectoscope. The secondary purposes were to compare the efficiency, complications and comfort of these techniques.

Conditions

Endometrial Polyps

Keywords

Endometrial polyp; Hysteroscopic resection; Morcellation

Outcome Measures

Primary Outcomes (1)

• Morcellation or resection time (minutes)

  From the cervical dilatation just before introducing the operative device until removal of the operative device assessed up to 25 minutes

Secondary Outcomes (7)

• The completeness of resection or not,

  10 weeks after surgery

• The total operating time (in minutes):

  from the beginning of diagnostic hysteroscopy to the end of operative hysteroscopy resection and removal of the operative device, assessed up to 25 minutes

• The amount of serum used (mL)

  At the end of surgery

• Perioperative complications,

  10 weeks after surgery

• The quality of vision defined by the operator on a scale of 0 to 5,

  At the end of surgery

Study Arms (2)

morcellation

EXPERIMENTAL

Procedure: Hysteroscopic morcellation

standard resection

ACTIVE COMPARATOR

Procedure: Standard hysteroscopic resection

Interventions

Standard hysteroscopic resection PROCEDURE

The endometrial polyp is resected by a transcervical approach in several chips using a mono or bipolar cove after distension of the uterine cavity under endoscopic control.

standard resection

Hysteroscopic morcellation PROCEDURE

The endometrial polyp is resected by a transcervical approach. During the procedure, the polyp is placed by suction against the window of the device, then cut by mechanical energy, in chips which are directly aspirated by the device.

morcellation

Eligibility Criteria

• Age: 18 Years+
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• All major patients with single endometrial polyp,
• Confirmed by a diagnostic hysteroscopy
• Greater than or equal to one centimeter in size with no upper size limit
• Patient giving informed consent
• Subject belonging to a social security organisme

You may not qualify if:

• Ongoing pregnancy or breastfeeding
• Progressive malignant gynecological pathology
• Evolutionary Genital infection
• Suspected malignancy before surgery
• Multiple Polyps
• Polypoid hyperplasia
• Associated submucosal myoma
• Person under guardianship
• Patient with contraindication to general anesthesia or spinal anesthesia
• Inability to give the eprosn informed information (comprehension difficulties ...)

Sponsors & Collaborators

• University Hospital, Strasbourg, France: lead

Study Sites (1)

University Hospital, Strasbourg, france

Strasbourg, 67000, France

Location

Related Publications (1)

• Stoll F, Lecointre L, Meyer N, Faller E, Host A, Hummel M, Boisrame T, Akladios C, Garbin O. Randomized Study Comparing a Reusable Morcellator with a Resectoscope in the Hysteroscopic Treatment of Uterine Polyps: The RESMO Study. J Minim Invasive Gynecol. 2021 Apr;28(4):801-810. doi: 10.1016/j.jmig.2020.07.007. Epub 2020 Jul 16.

  PMID: 32681995 RESULT

Study Officials

• Olivier GARBIN, MD

  University Hospital, Strasbourg, France

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 5, 2015
• First Posted: June 15, 2015
• Study Start: September 1, 2015
• Primary Completion: July 1, 2018
• Study Completion: July 1, 2018
• Last Updated: December 19, 2025

Record last verified: 2025-12

Locations

FR (1)