Resectoscopes

A resectoscope is a specialized endoscopic instrument used to perform surgical resections within a body cavity under direct visualization. It integrates an illumination and viewing system with an elongated working channel and a distal resection electrode. The device is employed in two major medical areas: gynecology for operative hysteroscopy and urology for transurethral resections, such as TURP.

Construction and energy delivery: The resectoscope comprises a rigid outer sheath with an integrated telescope, an irrigation/working channel, and a distal electrode loop or blade. The loop is activated by electric current to cut and coagulate tissue. Modern resectoscopes may use monopolar or bipolar energy. Monopolar systems require nonconductive irrigation fluids, whereas bipolar systems permit isotonic saline and reduce certain electrolyte risks.

Indications: In gynecology, resectoscopes are used for removal of submucosal fibroids and polyps, resection of intrauterine adhesions, and treatment of other intrauterine lesions during hysteroscopic procedures. In urology, they are employed for transurethral resection of prostatic tissue in benign prostatic hyperplasia and for related endoscopic resections within the urinary tract.

Risks and limitations: Potential complications include uterine or bladder injury, bleeding, infection, and fluid overload or electrolyte disturbances (especially with monopolar systems). The procedure requires skilled endoscopic technique and careful management of irrigation fluids. The resectoscope enables both tissue removal and coagulation, offering a therapeutic option in appropriately selected cases.

History: Development of endoscopic resection instruments evolved in the 20th century, with subsequent advances in optics and energy modalities improving safety and versatility.