Design: Video (case report)

Setting: Outpatient Department of Medical college

Patients or Participants: 30 years old infertile patient with heavy menstrual flow for 6 days with dysmenorrhea with G0 myoma on sonography

Interventions: Hysteroscopic tissue retrieval system in combination with 5 Fr bipolar needle. Slicing the myoma and then retrieving with tissue retrieval system

Measurements and Main Results: The procedure was done without any medication. Time taken was 14 mins and Visual analogue score was 4. Patient tolerated the procedure with no complications.

Conclusion: Hysteroscopic myomectomy for G0 myoma with tissue retrieval system in office is feasible. In this case the myoma being hard the window of the blade was unable to cut and aspirate an so 5 Fr bipolar needle was introduced to slice the myoma into small petals. and then the window of the blade could grip each petal and cut and aspirate facilitating complete removal in one sitting. The pressure settings on the Endomat were 60mm Hg pressure and 200ml/min irrigation. The visual analogue score was 4 with patient tolerating the procedure very well. Thus when the myoma is hard a combination of equipments. and techniques is necessary.