Alessandro Favilli

Background Hysteroscopy represents the gold standard for the diagnosis and treatment of intrauterine pathologies. The advent of the mini‐resectoscope heralded a new era in intrauterine surgery, both in inpatient and outpatient settings. Objectives To evaluate the effectiveness, safety, and feasibility of the mini‐resectoscope for the treatment of intrauterine pathologies. Search Strategy Electronic databases were searched for English‐language trials describing surgical procedures for uterine pathologies performed with a mini‐resectoscope until 30 April 2023. Selection Criteria Retrospective or prospective original studies reporting the treatment of uterine pathologies with mini‐resectoscope were deemed eligible for the inclusion. Data Collection and Analysis Data about study features, characteristics of included populations, surgical procedures, complications, and results/outcomes were collected. Results Seven papers that met the inclusion criteria were included in this systematic review. Quantitative analysis was not possible due to data heterogeneity. A descriptive synthesis of the results was provided accordingly to the pathology hysteroscopically removed/corrected: polyps and myomas, uterine septum, intrauterine synechiae, and isthmocele. Conclusions The mini‐resectoscope is poised to play a leading role in hysteroscopic surgery for many pathologies, both in inpatient and outpatient settings. Since some applications of the mini‐resectoscope have not yet been thoroughly investigated, future studies should address current knowledge gaps, designing high‐quality comparative trials on specific applications.

Background: Hysteroscopy currently represents the gold standard for the diagnosis and treatment of intrauterine pathologies. Recent technological progress has enabled the integration of diagnostic and operative time, leading to the “see and treat” approach. Diode laser technology is emerging as one of the most innovative and intriguing techniques in this context. Methods: A comprehensive search of the literature was carried out on the main databases. Only original studies reporting the treatment of intrauterine pathologies using diode laser were deemed eligible for inclusion in this systematic review (PROSPERO ID: CRD42023485452). Results: Eight studies were included in the qualitative analysis for a total of 474 patients undergoing laser hysteroscopic surgery. Eighty-three patients had female genital tract abnormalities, 63 had submucosal leiomyomas, 327 had endometrial polyps, and one patient had a scar pregnancy. Except for leiomyomas, whose technique already included two surgical times at the beginning, only seven patients required a second surgical step. Cumulative rates of intraoperative and postoperative complications of 2.7% and 0.6%, respectively, were reported. Conclusions: Diode laser through “see and treat” hysteroscopy appears to be a safe and effective method. However, additional studies with larger sample sizes and improved designs are needed to consolidate the evidence currently available in the literature.