Single-Port Perforated Intrauterine Device Removal With a Transabdominal Hysteroscope.

Abstract

In many aspects of gynecology, minimally invasive technique allows less pain and faster recovery. We are always striving to develop novel minimally invasive ways to help our patients. Perforated intrauterine devices (IUDs) have an incidence of 0.2-3.6 per 1,000 insertions and traditionally have been extracted with two- or three-port laparoscopy. In this article and video, we explain how to use a hysteroscope and hysteroscopic grasper transabdominally through a single laparoscopic trocar to extract a perforated IUD from the abdomen. Although some IUDs may be slightly more challenging to extract than others, different techniques may be used to locate and release IUDs from surrounding adhesions. This technique is appropriate for patients with intra-abdominal perforated IUDs without any evidence of other complications such as bowel or bladder perforation or abscess. A single-port approach with the use of a transabdominal hysteroscope should be considered for most patients with perforated IUDs because additional ports can be easily added thereafter if necessary.