Jacobs Volker R, Paepke Stefan, Schwarz-Boeger Ulrike, Fischer Thorsten, Pildner von Steinburg Stefanie, Plattner Birgit, Schmalfeldt Barbara, Schaaf Hansgeorg, Kiechle Marion
Frauenklinik (OB/GYN), Technical University Munich, Munich, Germany.
J Minim Invasive Gynecol. 2005 Sep-Oct;12(5):426-31. doi: 10.1016/j.jmig.2005.06.013.
Evaluation of the uterine cavity is limited with rigid 5-mm hysteroscopes because of the need for cervical dilatation, reduced movements inside the uterus, and no option for vision-guided biopsy. In cooperation with PolyDiagnost GmbH, Pfaffenhofen, Germany, a new type of flexible minihysteroscope with bendable tip was developed and evaluated.
Prospective and parallel observational interindividual evaluation of flexible minihysteroscope and standard hysteroscope for diagnostic hysteroscopy (Canadian Task Force classification II-3).
Obstetrics and gynecology department of a university clinic.
Nine women, average age 65.0 years (range 46-89 years), with indications for diagnostic hysteroscopy.
After defining requirements, a novel, thinner, and more flexible minihysteroscope, 18-cm long with a 2.67-mm outer diameter, was developed with straight zero-degree scope, 70-degree vision field, and 6000-pixel resolution. Two working channels, 1.2 mm and 0.55 mm, allow suction-irrigation and introduction of a 1.0-mm biopsy forceps or cytology brush. The tip of the instrument is 90-degree stageless bendable to both sides. Diagnostic hysteroscopy was performed with flexible minihysteroscope followed by standard rigid hysteroscopy to verify results.
From July 2003 through March 2004, both procedures were performed in nine patients with identical visual and histologic results. No complications occurred. No cervix-dilating instruments were necessary for introduction of the flexible minihysteroscope. Visualization of the entire uterine cavity is improved with the flexible scope because a bendable tip allows better peripheral vision (e.g., of the openings of the tubes). However, movement of the tip should be performed carefully due to potential risk of uterine perforation.
This new flexible minihysteroscope is less invasive compared with standard rigid hysteroscopy, which supports performance of ambulatory hysteroscopy and makes increased movements and vision-guided biopsy inside the uterine cavity possible.
由于需要宫颈扩张、子宫内活动受限以及无法进行视觉引导活检，5毫米刚性宫腔镜对子宫腔的评估受到限制。与德国普法芬霍芬的PolyDiagnost GmbH公司合作，研发并评估了一种新型的带有可弯曲尖端的柔性微型宫腔镜。
对柔性微型宫腔镜和标准宫腔镜进行诊断性宫腔镜检查的前瞻性平行个体间评估（加拿大工作组分类II-3）。
大学诊所的妇产科。
9名女性，平均年龄65.0岁（范围46 - 89岁），有诊断性宫腔镜检查指征。
在明确需求后，研发了一种新型、更细且更灵活的微型宫腔镜，长18厘米，外径2.67毫米，具有直的零度视野镜、70度视野和6000像素分辨率。两个工作通道，分别为1.2毫米和0.55毫米，允许进行吸引冲洗以及插入1.0毫米活检钳或细胞学刷。器械尖端可在两侧无阶段地弯曲90度。先用柔性微型宫腔镜进行诊断性宫腔镜检查，然后用标准刚性宫腔镜检查以验证结果。
2003年7月至2004年3月，对9名患者进行了这两种检查，视觉和组织学结果相同。未发生并发症。插入柔性微型宫腔镜无需宫颈扩张器械。柔性宫腔镜能改善对整个子宫腔的观察，因为可弯曲尖端能提供更好的周边视野（如输卵管开口）。然而，由于存在子宫穿孔的潜在风险，尖端的操作应谨慎。
与标准刚性宫腔镜相比，这种新型柔性微型宫腔镜侵入性更小，有助于门诊宫腔镜检查的开展，并使子宫腔内增加活动和视觉引导活检成为可能。
