Hysteroscopic morcellator versus hysteroscopic scissors for endometrial polypectomy: a retrospective study

Objective: To compare hysteroscopic morcellation with hysteroscopic scissors for endometrial polypectomy in terms of operating time, the need for cervical dilatation, blood loss, complications, and completeness of removal.Methods: Medical records of patients who underwent hysteroscopic polypectomy using either the Intrauterine BIGATTI Shaver (IBS) system or hysteroscopic scissors between January 2020 and August 2022 at the United Christian Hospital or Tseung Kwan O Hospital were retrospectively reviewed.Results: A total of 1063 women were operated on using the IBS (n=132) or hysteroscopic scissors (n=931).More patients in the IBS group required general/spinal anaesthesia (97.7% vs 71.1%, p<0.001) and cervical dilatation (77.3% vs 30.1%, p<0.001).The operating time was shorter in the IBS group when removing one polyp (18.6 vs 20.0 min, p=0.049) and when performed by trainees independently (17.9 vs 19.8 min, p=0.007) but was longer when performed by specialists (22.7 vs 19.7 min, p<0.001).All patients in the IBS group achieved complete removal of polyps, compared with five patients with incomplete removal of polyps in the scissors group.Conclusion: Compared with hysteroscopic scissors, hysteroscopic morcellation requires less operating time when removing one polyp and when performed by trainees independently and is more effective in achieving complete removal, but the need for cervical dilatation and anaesthesia is more for hysteroscopic morcellation.