Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2023; 11(36): 8557-8562
Published online Dec 26, 2023. doi: 10.12998/wjcc.v11.i36.8557
LiNA OperaScopeTM for microwave endometrial ablation for endometrial polyps with heavy menstrual bleeding: A case report
Kaoru Kakinuma, Toshiyuki Kakinuma, Kyouhei Ueyama, Takumi Shinohara, Rora Okamoto, Kaoru Yanagida, Nobuhiro Takeshima, Michitaka Ohwada
Kaoru Kakinuma, Toshiyuki Kakinuma, Kyouhei Ueyama, Takumi Shinohara, Rora Okamoto, Kaoru Yanagida, Nobuhiro Takeshima, Michitaka Ohwada, Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Nasushiobara, Japan
Author contributions: Kakinuma T contributed to conceptualization, methodology, software, validation, original draft preparation, manuscript review and editing, visualization, supervision, and project administration; All authors contributed to formal analysis, investigation, resources, and data curation, and have read and agreed to the published version of the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Toshiyuki Kakinuma, MD, PhD, Doctor, Professor, Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3, Iguchi, Tochigi 329-2763, Nasushiobara, Japan. tokakinuma@gmail.com
Received: October 3, 2023
Peer-review started: October 3, 2023
First decision: November 22, 2023
Revised: November 28, 2023
Accepted: December 11, 2023
Article in press: December 11, 2023
Published online: December 26, 2023
Processing time: 79 Days and 23.4 Hours
Abstract
BACKGROUND

The procedure for microwave endometrial ablation (MEA) follows established MEA practice guidelines but requires hysteroscopic observation of the uterine lumen before and after MEA. When a luminal uterine lesion is recognized, its removal requires preoperative dilation of the cervix because the outer diameter of a conventional rigid hysteroscope is 8.7 mm. Recently, a fully disposable rigid hysteroscope (LiNA OperaScopeTM) with a narrow diameter (4.4 mm) and forceps capable of extracting endometrial lesions has become available.

CASE SUMMARY

Here, we report a case of heavy menstrual bleeding (HMB) complicated by endometrial polyps where MEA was performed after removing endometrial polyps using the LiNA OperaScopeTM device. A 48-year-old woman with three prior pregnancies and three deliveries was referred to our hospital for further examination and treatment after being diagnosed with HMB 2 years earlier. The patient underwent MEA following endometrial polypectomy using LiNA OperaScopeTM. After MEA, endometrial cauterization was again examined using the LiNA OperaScopeTM, and the procedure was completed. No preoperative cervical dilation was performed. The patient’s clinical course was favorable, and she was discharged 3 h after surgery. One month after surgery, menstruation resumed, and both HMB and dysmenorrhea improved markedly from 10 preoperatively to 1 postoperatively, as assessed subjectively using the visual analog scale. The patient’s postoperative course was uneventful with no complications.

CONCLUSION

LiNA OperaScopeTM can be a minimally invasive treatment for MEA of HMB with uterine lumen lesions.

Keywords: Heavy menstrual bleeding; Microwave endometrial ablation; Endometrial polyp; Hysteroscopy; Minimally invasive surgery; Dysmenorrhea; Case report

Core Tip: LiNA OperaScopeTM is a fully disposable rigid hysteroscope with an outer diameter of 4.4 mm, narrower than conventional hysteroscopes, and equipped with forceps capable of excising endometrial lesions. We report a case of heavy menstrual bleeding (HMB) with endometrial polyps where microwave endometrial ablation (MEA) was performed after endometrial polyp removal using LiNA OperaScopeTM. This case suggests that MEA using the LiNA OperaScopeTM can remove luminal lesions without preoperative cervical dilation and can be a less invasive treatment option than conventional techniques for patients with HMB presenting with endometrial polyps.