RCOG classification of operative hysteroscopy levelsLevel 1 | - Diagnostic hysteroscopy with target biopsy
- Removal of simple polyps
- Removal of intrauterine contraceptive device
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Level 2 | - Proximal fallopian tube cannulation
- Minor Asherman's syndrome
- Removal of pedunculated fibroid (type 0) or large polyp
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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
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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.
A passive resectoscope used for hysteroscopic surgery