A lariat-based dilatation device for hysteroscopy: an in vitro study

Hysteroscopy is a minimally invasive surgical procedure that requires the access to the uterine cavity for the treatment of intrauterine and endocervical lesions. This operation has been regarded as the golden standard for the therapeutic and diagnostic methods of many uterine diseases, such as dilation and curettage (D&C), sonohysterogram, hysterosalpingogram, and submucous fibroids (1,2). A preliminary cervical canal dilatation is required for standard resectoscopes to pass through a cavity to obtain an appropriate operating space, and plays a vital role in a successful operation procedure. Unfortunately, artificially ripening the cervix is still a clinical challenge, although many mechanical or pharmacological methods exist. A wide variety of cases, such as cervical stenosis, extreme uterine flexion or version, congenital anomalies, and scarring of the cervical anatomy by previous surgeries, can induce technical difficulties and complicated procedures during hysteroscopy (3). The failure ratio of the outpatient hysteroscopic procedures caused by the cervical stenosis and undue pain during the negotiation of the endocervical canal can be as high as 47 percent (4)