Operative hysteroscopy

RCOG classification of operative hysteroscopy levels
Level 1	Diagnostic hysteroscopy with target biopsy Removal of simple polyps Removal of intrauterine contraceptive device
Level 2	Proximal fallopian tube cannulation Minor Asherman's syndrome Removal of pedunculated fibroid (type 0) or large polyp
Level 3	Division/resection of uterine septum Major Asherman's syndrome Endometrial resection or ablation Resection of submucous fibroid (type 1 or type 2) Repeat endometrial ablation or resection

Issues related to operative hysteroscopy

Needs advanced training and high level of expertise.
Usually requires cervical dilatation to accommodate larger sheaths and operating instruments.
Intravasation of distension medium as a consequence to operative intervention.
Difficulty in obtaining a good view due to bleeding as a result of surgical intervention.