Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 13 , ISSUE 3 ( May-June, 2021 ) > List of Articles

RESEARCH ARTICLE

Holmium:YAG Laser: A Better Tool for Hysteroscopic Septal Transection

Anuja V Kulkarni, Vishvas M Kulkarni, Rameshwari Alahabade, Prachi D Ruikar, Aditya V Kulkarni

Keywords : Holmium:YAG, Hysteroscopic metroplasty, Laser, Septal resection, Uterine septum

Citation Information : Kulkarni AV, Kulkarni VM, Alahabade R, Ruikar PD, Kulkarni AV. Holmium:YAG Laser: A Better Tool for Hysteroscopic Septal Transection. J South Asian Feder Obs Gynae 2021; 13 (3):114-117.

DOI: 10.5005/jp-journals-10006-1887

License: CC BY-NC 4.0

Published Online: 09-09-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim and objective: To evaluate the feasibility of the use of Holmium:YAG (Ho:YAG) laser for hysteroscopic transection of uterine septum. Study design: A retrospective study of 36 patients with uterine septum who were treated with hysteroscopic metroplasty using Ho:YAG laser from October 2012 to August 2017. Design classification: Canadian Task Force Classification–III. Settings: A 50-bedded hospital dedicated exclusively to obstetrics, gynecology, infertility, and urology, at a district place in India. Materials and methods: Hysteroscopic transection of the uterine septum with Ho:YAG laser was performed in 36 patients, using a 400-micron bare quartz fiber and energy equivalent to15 W. Normal saline was used as the distending medium. The operative parameters and complications were studied and compared with other studies using other energy sources for the surgery. Postoperative follow-up of 29 patients was done for 18 months to study their reproductive outcome. Relook hysteroscopy was done in eight patients who did not conceive in 8 months of the first surgery. Results: The average time taken for the procedure was 17 minutes (10–25 minutes). There were no intraoperative or immediate postoperative complications. On relook hysteroscopy in eight patients, a residual septum was found in one patient and few intrauterine adhesions were found in two patients, which were cut using Ho:YAG laser. Of the 29 patients who had been followed, 23 patients (79.3%) conceived. Out of these 23 conceived patients, 3 patients (13.0%) had abortions, two patients (8.7%) had preterm deliveries at 32 and 34 weeks, respectively, and 18 patients (78.3%) delivered after 35 weeks. So, there were a total of 20 live births (86.9% of conceptions). Conclusion: Ho:YAG laser is a precise, simple, effective, and safe tool for the procedure of hysteroscopic transection of the uterine septum.


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