{"title":"Suture Fixation of Levonorgestrel-Releasing Device Using the Hysteroscopic Surgery System.","authors":"Zhengwei Lai, Jin Dong, Ying Zhang, Jun Wu","doi":"10.4293/JSLS.2024.00076","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The levonorgestrel-releasing intrauterine system (LNG-IUS) is a widely recognized method for contraception and the management of various gynecological conditions. However, the placement of LNG-IUS can be particularly challenging in patients with large or anatomically irregular uteri. The objective of this study was to evaluate the efficacy and safety of hysteroscopic cold-knife-assisted suture fixation of the LNG-IUS in the uteri of patients diagnosed with adenomyosis.</p><p><strong>Methods: </strong>We retrospectively analyzed the data of patients who underwent LNG-IUS placement with the assistance of cold-knife hysteroscopy. The evaluation criteria included surgical success rates, postoperative complications, and subsequent follow-up of LNG-IUS.</p><p><strong>Results: </strong>Our findings indicated that LNG-IUS placement was successfully achieved with cold-knife hysteroscopy, even in cases characterized by large uterine volume or abnormal uterine morphology. The procedure demonstrated a low incidence of postoperative complications, with no instances of device expulsion or displacement. Additionally, it resulted in a reduction of vaginal bleeding and alleviation of dysmenorrhea.</p><p><strong>Conclusion: </strong>Hysteroscopic cold-knife-assisted suture fixation of LNG-IUS offers an effective solution for patients with a history of device expulsion, significantly reducing the expulsion rate and demonstrating high safety and efficacy.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"29 2","pages":""},"PeriodicalIF":1.4000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039163/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4293/JSLS.2024.00076","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/29 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The levonorgestrel-releasing intrauterine system (LNG-IUS) is a widely recognized method for contraception and the management of various gynecological conditions. However, the placement of LNG-IUS can be particularly challenging in patients with large or anatomically irregular uteri. The objective of this study was to evaluate the efficacy and safety of hysteroscopic cold-knife-assisted suture fixation of the LNG-IUS in the uteri of patients diagnosed with adenomyosis.
Methods: We retrospectively analyzed the data of patients who underwent LNG-IUS placement with the assistance of cold-knife hysteroscopy. The evaluation criteria included surgical success rates, postoperative complications, and subsequent follow-up of LNG-IUS.
Results: Our findings indicated that LNG-IUS placement was successfully achieved with cold-knife hysteroscopy, even in cases characterized by large uterine volume or abnormal uterine morphology. The procedure demonstrated a low incidence of postoperative complications, with no instances of device expulsion or displacement. Additionally, it resulted in a reduction of vaginal bleeding and alleviation of dysmenorrhea.
Conclusion: Hysteroscopic cold-knife-assisted suture fixation of LNG-IUS offers an effective solution for patients with a history of device expulsion, significantly reducing the expulsion rate and demonstrating high safety and efficacy.
期刊介绍:
JSLS, Journal of the Society of Laparoscopic & Robotic Surgeons publishes original scientific articles on basic science and technical topics in all the fields involved with laparoscopic, robotic, and minimally invasive surgery. CRSLS, MIS Case Reports from SLS is dedicated to the publication of Case Reports in the field of minimally invasive surgery. The journals seek to advance our understandings and practice of minimally invasive, image-guided surgery by providing a forum for all relevant disciplines and by promoting the exchange of information and ideas across specialties.