scholarly journals The use of hysteroscopic metroplasty with diode laser to increase endometrial volume in women with septate uterus: preliminary results

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Luigi Nappi ◽  
Maddalena Falagario ◽  
Stefano Angioni ◽  
Vincenzo De Feo ◽  
Michele Bollino ◽  
...  
Keyword(s):  
Diode Laser ◽  
Transvaginal Ultrasound ◽  
Complete Removal ◽  
Safe Procedure ◽  
Septate Uterus ◽  
Median Increase ◽  
Mullerian Ducts ◽  
Endometrial Volume ◽  
3D Tv

Abstract Background Septate uterus is a common Mullerian ducts anomaly. The aim of our pilot study was the evaluation of diode laser hysteroscopic metroplasty efficacy to increase endometrial volume in women with septate uterus. Results We prospectively enrolled 10 consecutive patients with septate uterus undergoing office hysteroscopic metroplasty with diode laser between February and November 2019. Endometrial volume was evaluated before and 3 months after surgery using 3D transvaginal ultrasound. The surgical procedure was uncomplicated in all patients, the endometrial volume increased at 3 months follow-up (the median increase was 1.9 cm3 (range 1.7–2.1), and there was a complete removal of septum with no intrauterine synechiae at follow-up hysteroscopy. Conclusions Office hysteroscopic metroplasty with diode laser is a safe procedure and has preliminary showed to increase endometrial volume. The increase in endometrial volume by 3D-TV US could be used as a prognostic factor for the reproductive outcomes.

scholarly journals The Use of Hysteroscopic Metroplasty With Diode Laser to Increase Endometrial Volume in Women With Septate Uterus: Preliminary Results

2020 ◽  
Author(s):  
Luigi Nappi ◽  
Maddalena Falagario ◽  
Stefano Angioni ◽  
Vincenzo De Feo ◽  
Michele Bollino ◽  
...  
Keyword(s):  
Diode Laser ◽  
Surgical Procedure ◽  
Transvaginal Ultrasound ◽  
Complete Removal ◽  
Safe Procedure ◽  
Septate Uterus ◽  
Preliminary Results ◽  
Mullerian Ducts ◽  
Endometrial Volume

Abstract Background Septate uterus is a common Mullerian ducts anomaly. The aim of our study was the evaluation of the efficacy of hysteroscopic metroplasty with diode laser to increase endometrial volume in women with septate uterus.Results We prospectively enrolled 10 consecutive patients with septate uterus who underwent office hysteroscopic metroplasty with diode laser between february 2019 and november 2019. Endometrial volume was evaluated before and 3 months after surgery using 3D transvaginal ultrasound. The surgical procedure was uncomplicated in all patients, the endometrial volume increased at 3 months follow up and there was a complete removal of septum with no intrauterine synechiae at follow up hysteroscopy. Conclusions Office hysteroscopic metroplasty with diode laser is a safe procedure and has preliminary showed to increase endometrial volume.

scholarly journals A Prospective Intervention Trial on Tailored Radiofrequency Ablation of Uterine Myomas

Medicina ◽  
2020 ◽  
Vol 56 (3) ◽  
pp. 122
Author(s):  
Alessandro Fasciani ◽  
Giovanni Turtulici ◽  
Giacomo Siri ◽  
Simone Ferrero ◽  
Rodolfo Sirito
Keyword(s):  
Quality Of Life ◽  
New Technologies ◽  
Transvaginal Ultrasound ◽  
Safe Procedure ◽  
Ultrasound Guided ◽  
Post Intervention ◽  
Vaginal Ultrasound ◽  
Uterine Myomas

Background and Objective: Investigating the use of radiofrequency myolysis (RFM) for the treatment of fibroids through less invasive access by combining transvaginal ultrasound, hysteroscopy and laparoscopy. Materials and Methods: Fifty-four premenopausal women with 106 symptomatic uterine myomas. Patients underwent RFM in three ways: Vaginal Ultrasound-guided RFM (VU-RFM), Laparoscopic RFM (L-RFM) and Hysteroscopic-RFM (H-RFM). The mean patient age was 43 years; 52 symptomatic uterine myomas were subserosal, 44 intramural and 10 submucosal. The outcomes evaluated at 1 and 12 months after RFM were myoma size (volume-diameter), “Uterine Fibroid Symptom and Quality of Life (UFS-QOL)” questionnaire and a 10-point Visual Analogue Scale (VAS). The therapy was completed with a single ablation in all patients, no complication was registered. The average number of fibroids treated per intervention was two with the use of different accesses: 64/106 VU-RFMs (60.4%), 32/106 L-RFMs (30.2%) and 10/106 H-RFMs (9.4%). Results: Volume and diameter of fibroids were significantly reduced by, respectively, 51.3% and 20.1% in the first 30 days post-intervention (p < 0.001) up to a maximum of 73.5% and 37.1% after the second follow-up visit at 12 months (p < 0.001). A similar trend was shown in terms of disability with a progressive and significant reduction of symptoms (menorrhagia, dysmenorrhea, dyspareunia and pollakiuria) demonstrated by percentage variation of UFS-QOL Symptom Severity and VAS scores to −74.3% and −45.3% as well as −84.9% and −74.3%, respectively, at 1 and 12 months after RFM (p < 0.001). An overall improvement in the quality of life was also demonstrated by a significant increase in the UFS-QOL total score of +38.2% in the first 30 days post-intervention up to +44.9% after the second follow-up visit at 12 months (p < 0.001). The overall average surgery time of the RFM for each patient was 48 minutes, and the time to treat each fibroid by Vaginal Ultrasound-guided RFM (23 min) was found to be significantly less than those of laparoscopy or hysteroscopy (respectively 35 and 34 min) (p < 0.05). An electromagnetic virtual needle tracking system (VNTS) was successfully tested during the RFM procedures, and real-time contrast-enhanced ultrasound (CEUS) has proven to be effective in determining the duration of myolysis through the identification of eventual residual areas of enhancement within the fibroids. Conclusion: Radiofrequency can be considered a minimally invasive and safe procedure for the treatment of uterine myomas through the customization and possible combination of transvaginal, laparoscopic or hysteroscopic accesses. The standardization of the ablation technique with pre-intervention biopsy and new technologies such as VNTS and CEUS spares healthy uterine tissue and may change the future management of symptomatic uterine fibroids.

scholarly journals UTERUS BIKORNU

2019 ◽  
Vol 2 (2) ◽  
pp. 115-118
Author(s):  
Herti Marni ◽  
Ferdinal Ferry ◽  
Bobby Indra Utama
Keyword(s):  
Urinary Tract ◽  
Pregnant Women ◽  
Acute Abdomen ◽  
Congenital Abnormalities ◽  
Transvaginal Ultrasound ◽  
Uterine Cavity ◽  
Mullerian Ducts ◽  
Uterus Bicornis ◽  
Left And Right

Background : Uterus bicornis subseptum is a deformity of the uterus such as the shape of the heart, the fundus appears to be curved inward, and has a barrier or wall inside to the uterine cavity. This abnormality occurs due to failure of the fusion of the left and right mullerian ducts. If pregnant, women who have this form of the uterus will usually experience a location abnormality, in which the fetus is often transverse or breech. However, women who have this disorder sometimes find it difficult to get pregnant so they experience infertility. In addition, there is usually a disturbance in the formation of the kidneys, but in this patient there was no abnormality in the urinary tract. In cases where the patient does not have children and a bicornu uterine abnormality is found, uterine repair is performed and it is hoped that with the uterine anatomy returning to normal, the patient can become pregnant.Objective : Discuss the management of cases of congenital abnormalities of the internal genital organs in patients with a bicornu uterus.Method : Case Report.Case : Reported a patient aged 25 years with primary infertility 4 years and a bicornu uterus. In patients, chromotubation was performed first, after chromotubation, the patient was performed metrosplasty to remove the bulkhead in the uterus and to repair the uterus. During the post-op follow-up at the hospital the patient did not show any signs of infection or acute abdomen, then the patient was discharged on day 5. The patient was advised to go to the OBGYN polyclinic regularly for further follow-up to the success of his uterine repair. Assessment can be done in several ways including transvaginal ultrasound to assess whether there is adhesions to the endometrium from the results of uterine repair, HSG, SIS or hysteroscopy can also be done in assessing the success of metroplasty in this patient.Conclusion : After metrosplasty in a patient with a bicornu uterus, further follow-up is required to determine the success of this procedure by performing a follow-up ultrasound.Keywords: Bicornu uterus, metroplasty

scholarly journals Uterine Fundus Remodeling after Hysteroscopic Metroplasty: A Prospective Pilot Study

2021 ◽  
Vol 10 (2) ◽  
pp. 260
Author(s):  
Paolo Casadio ◽  
Giulia Magnarelli ◽  
Mariangela La Rosa ◽  
Andrea Alletto ◽  
Alessandro Arena ◽  
...  
Keyword(s):  
Wall Thickness ◽  
Transvaginal Ultrasound ◽  
Three Dimensional ◽  
Second Step ◽  
Septate Uterus ◽  
Uterine Malformation ◽  
Uterine Septum ◽  
Uterine Fundus ◽  
Congenital Uterine Malformation

The septate uterus is the most common congenital uterine malformation and is treated by hysteroscopic metroplasty. There are few studies on the fundal uterine changes that occur after surgery. We designed a pilot prospective observational study to evaluate by three-dimensional transvaginal ultrasound (3D-TVS) the changes not only of the internal fundal uterine profile, but also of the external one, after hysteroscopic metroplasty. Sixty women who underwent hysteroscopic metroplasty for partial or complete uterine septum (U2a and U2b subclasses of ESHRE/ESGE classification) were enrolled. We performed 3D-TVS after surgery confirming optimal removal of the septum. However, at ultrasound follow-up after three months, we observed a significant increase (p < 0.001) in the residual septum (Zr) (3.7 mm (95% CI: 3.1–4.4)), the myometrial wall thickness (Y) (2.5 mm (95% CI: 2.0–3.0)) and the total fundal wall thickness (Y + Zr) (6.2 mm (95% CI: 5.5–6.9)). Forty-three patients (72%) required a second step of hysteroscopic metroplasty. Moreover, the shape of uterine fundus changed in 58% of cases. We actually observed a remodeling of the uterine fundus with modifications of its external and internal profiles. Therefore, we propose to always perform a second ultrasound look at least three months after the metroplasty to identify cases that require a second- step metroplasty.

O-139 Complete removal of uterine septum tissue as a wedge, an alternative method for patients suffering from recurrent pregnancy loss or infertility, a retrospective cohort study

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
F Razzaghi Kashani ◽  
R Zargham ◽  
S Amirajam ◽  
H Jadda ◽  
S Razi ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Retrospective Cohort ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
Complete Removal ◽  
Septate Uterus ◽  
History Of ◽  
Uterine Septum

Abstract Study question Is hysteroscopic wedge septectomy (HWS) an effective and safe method for reducing the risk of miscarriage and improving the reproductive outcome in patients with recurrent pregnancy loss or infertility history? Summary answer HWS is a safe and effective method for RPL and infertility cases with statistically significant improvement in pregnancy chances and reproductive outcomes. What is known already With regard to the persisting uncertainty around the effectiveness of septum resection in recurrent miscarriage and infertility cases, there may be alternative methods to better address the pathophysiology of septum. There are different explanations for the poor reproductive performance with uterine septum: poor vascularisation of a highly fibrous implantation site, low sensitivity of endometrial receptors covering the septa, its “myoma-like” composition, and finally higher uterine vascular resistance. Complete removal of this abnormal tissue rather than just incising it may not only enhance challenging the pathogenesis but also expand the endometrial volume, an objective parameter by which to predict endometrial receptivity. Study design, size, duration In this retrospective cohort study, 214 consecutive patients, aged 33.3±4.8, diagnosed with a septate uterus based on ESHRE classification who had been under HWS between April 2017 and January 2020 due to recurrent miscarriage or at least one failed embryo transfer, met the enrollment criteria. With 11 to 36 months follow up, gathering of follow up data was managed between August till the end of Nov 2020, when the last new information was included. Participants/materials, setting, methods Patients with a history of RPL or at least one failed ET who were diagnosed as septate uterus by 2D, 3D, or hysteroscopy have been under HWS in a tertiary infertility and recurrent abortion treatment/educational setting. Those with BMI≥32, day 3 FSH≥13 mIU/mL, acquired or hereditary thrombophilia, thyroid disease, and myomatous uterus were excluded. HWS’s goal was to remove the septum as a wedge, cutting with 7Fr scissors, in its entirety as much as possible. Main results and the role of chance 39 patients who experienced 1 to 8 failed ET and 175 with 2 to 10 miscarriages, were enrolled in the study. The average septum size based on the depth of the removed wedge was 1.73±0.86 cm. There was an increase of 1.68±0.9 cm in uterine depth and 2.28±0.6 ml in uterine capacity measured by uterine sound and inflation of 8F Folley catheter balloon inside the cavity, respectively. The procedure took 35.75±8.7 minutes. Intraoperative, postoperative, or late complications during the next pregnancies were not reported. 7 patients (17.9%) in failed ET group, conceived spontaneously, before another embryo transfer attempt. Embryo transfer in the remaining 32 cases resulted in 25 (78.1%) clinical pregnancies. 2 miscarried (6.2%), 5(15.6%) are ongoing after 20 weeks of gestation and 25 (78.1%) have resulted in live births. Among 126 clinical pregnancies in RPL group, 16 patients (12.6%) experienced another miscarriage; 6%, 11.3%, and 25% in patients with a previous history of 2, 3, and 4 or more miscarriages, respectively. There was a significant drop in odds of post-procedure miscarriage from 22.7% to 6% (p:0.005) and from 27.8% to 11.3% (p:0.27) with 2 and 3 miscarriage history, respectively. This reduction was not significant with more than 3 losses. Limitations, reasons for caution We acknowledge the inherent limitations of this retrospective observational study, confining direct inferences. Our goal is to encourage future prospective studies to compare the effectiveness of different methods of hysteroscopy with or without involving the removal of septal tissue. An RCT comparing metroplasty vs expectant management seems infeasible, though. Wider implications of the findings Our findings suggest that timely removal of the uterine septal tissue with hysteroscopy will result in favorable reproductive outcomes in patients with RPL and/or infertility. Also, a history of a normal term pregnancy before subsequent successive losses does not rule out the uterine septum and calls for a thorough assessment. Trial registration number not applicable

Surgical reconstruction for unilateral iliac artery lesions in patients younger than 50 years

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 474-481 ◽  
Author(s):  
Radak ◽  
Babic ◽  
Ilijevski ◽  
Jocic ◽  
Aleksic ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Limb Salvage ◽  
Iliac Artery ◽  
Graft Patency ◽  
Long Term Results ◽  
Surgical Reconstruction ◽  
Safe Procedure ◽  
Term Survival

Background: To evaluate safety, short and long-term graft patency, clinical success rates, and factors associated with patency, limb salvage and mortality after surgical reconstruction in patients younger than 50 years of age who had undergone unilateral iliac artery bypass surgery. Patients and methods: From January 2000 to January 2010, 65 consecutive reconstructive vascular operations were performed in 22 women and 43 men of age < 50 years with unilateral iliac atherosclerotic lesions and claudication or chronic limb ischemia. All patients were followed at 1, 3, 6, and 12 months after surgery and every 6 months thereafter. Results: There was in-hospital vascular graft thrombosis in four (6.1 %) patients. No in-hospital deaths occurred. Median follow-up was 49.6 ± 33 months. Primary patency rates at 1-, 3-, 5-, and 10-year were 92.2 %, 85.6 %, 73.6 %, and 56.5 %, respectively. Seven patients passed away during follow-up of which four patients due to coronary artery disease, two patients due to cerebrovascular disease and one patient due to malignancy. Limb salvage rate after 1-, 3-, 5-, and 10-year follow-up was 100 %, 100 %, 96.3 %, and 91.2 %, respectively. Cox regression analysis including age, sex, risk factors for vascular disease, indication for treatment, preoperative ABI, lesion length, graft diameter and type of pre-procedural lesion (stenosis/occlusion), showed that only age (beta - 0.281, expected beta 0.755, p = 0.007) and presence of diabetes mellitus during index surgery (beta - 1.292, expected beta 0.275, p = 0.026) were found to be significant predictors of diminishing graft patency during the follow-up. Presence of diabetes mellitus during index surgery (beta - 1.246, expected beta 0.291, p = 0.034) was the only variable predicting mortality. Conclusions: Surgical treatment for unilateral iliac lesions in patients with premature atherosclerosis is a safe procedure with a low operative risk and acceptable long-term results. Diabetes mellitus and age at index surgery are predictive for low graft patency. Presence of diabetes is associated with decreased long-term survival.

Treatment of varicose tributaries with sclerotherapy with polidocanol 0.5 % foam

VASA ◽  
2010 ◽  
Vol 39 (2) ◽  
pp. 169-174 ◽  
Author(s):  
Reich-Schupke ◽  
Weyer ◽  
Altmeyer ◽  
Stücker
Keyword(s):  
Scientific Evidence ◽  
Daily Practice ◽  
Severe Adverse Effect ◽  
Safe Procedure ◽  
Efficacy And Safety ◽  
Foam Sclerotherapy ◽  
History Of ◽  
One Year ◽  
Additional Therapy

Background: Although foam sclerotherapy of varicose tributaries is common in daily practice, scientific evidence for the optimal sclerosant-concentration and session-frequency is still low. This study aimed to increase the knowledge on foam sclerotherapy of varicose tributaries and to evaluate the efficacy and safety of foam sclerotherapy with 0.5 % polidocanol in tributaries with 3-6 mm in diameter. Patients and methods: Analysis of 110 legs in 76 patients. Injections were given every second or third day. A maximum of 1 injection / leg and a volume of 2ml / injection were administered per session. Controls were performed approximately 6 months and 12 months after the start of therapy. Results: 110 legs (CEAP C2-C4) were followed up for a period of 14.2 ± 4.2 months. Reflux was eliminated after 3.4 ± 2.7 injections per leg. Insufficient tributaries were detected in 23.2 % after 6.2 ± 0.9 months and in 48.2 % after 14.2 ± 4.2 months, respectively. Only 30.9 % (34 / 110) of the legs required additional therapy. In 6.4 % vein surgery was performed, in 24.5 % similar sclerotherapy was repeated. Significantly fewer sclerotherapy-sessions were required compared to the initial treatment (mean: 2.3 ± 1.4, p = 0.0054). During the whole study period thrombophlebitis (8.2 %), hyperpigmentation (14.5 %), induration in the treated region (9.1 %), pain in the treated leg (7.3 %) and migraine (0.9 %) occurred. One patient with a history of thrombosis developed thrombosis of a muscle vein (0.9 %). After one year there were just hyperpigmentation (8.2 %) and induration (1.8 %) left. No severe adverse effect occurred. Conclusions: Foam sclerotherapy with injections of 0.5 % polidocanol every 2nd or 3rd day, is a safe procedure for varicose tributaries. The evaluation of efficacy is difficult, as it can hardly be said whether the detected tributaries in the controls are recurrent veins or have recently developed in the follow-up period. The low number of retreated legs indicates a high efficacy and satisfaction of the patients.

Exclusive Bilateral Internal Thoracic Artery Grafts for Myocardial Revascularization Requiring Four Anastomoses or More: Outcomes from a Single Center Experience

2016 ◽  
Vol 65 (04) ◽  
pp. 265-271
Author(s):  
Andrea Perrotti ◽  
Enrica Dorigo ◽  
Camille Durst ◽  
Djamel Kaili ◽  
Sidney Chocron ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Internal Thoracic Artery ◽  
Artery Bypass ◽  
Univariate Analysis ◽  
Bypass Graft ◽  
Myocardial Revascularization ◽  
Wound Complication ◽  
Safe Procedure ◽  
Off Pump

Introduction Multivessel coronary artery bypass graft (CABG) with bilateral internal thoracic arteries (BITA) has only been uncommon and technically demanding. We describe our experience with BITA only CABGs requiring ≥ 4 anastomoses. Material and Methods The department's database was queried for patients undergoing isolated CABG with ≥ 4 anastomoses. The surgical technique included systematically a right internal thoracic artery (ITA) of left ITA Y graft. The multivariate model included variables with a p < 0.3 at univariate analysis. Results Between January 2006 and December 2009, 251 consecutive patients (71 ± 10 years) (on-pump: 130, off-pump: 121) had CABG with ≥ 4 anastomoses, representing 21% of total isolated CABGs for the same period; all patients received a totally arterial BITA only revascularization. Follow-up was 4.9 ± 1.6 years. Overall and cardiac cumulative survivals were 78 and 92%, respectively, at 5 years. The occurrence of any major postoperative complication was associated with overall and cardiac mortality (odds ratio [OR]: 3.6, 95% confidence interval [CI]: 1.3–9.9 and OR: 5.4, 95% CI: 1.3–21.9, respectively). Major sternal wound complication requiring surgical revision was not associated with impaired glucose control (n = 9; diabetics: 6/82, 7.3%; nondiabetics: 3/169, 1.8%, p = 0.06). Preoperative kidney failure was associated with incomplete revascularization (OR: 6.2; 95% CI: 1.2–33.5), that was unfailingly due to ungraftable right coronary artery targets. Discussion BITA only revascularization was a valuable and safe procedure, with favorable results in terms of morbidity and mortality at a 5 years' follow-up.

Long-Term Follow-Up of Early Cochlear Implant Device Activation

2021 ◽  
pp. 1-11
Author(s):  
Stefanie Bruschke ◽  
Uwe Baumann ◽  
Timo Stöver
Keyword(s):  
Speech Recognition ◽  
Side Effects ◽  
Cochlear Implant ◽  
Surgical Techniques ◽  
Control Group ◽  
First Year ◽  
Safe Procedure ◽  
Sound Processor

Background: The cochlear implant (CI) is a standard procedure for the treatment of patients with severe to profound hearing loss. In the past, a standard healing period of 3–6 weeks occurred after CI surgery before the sound processor was initially activated. Advancements of surgical techniques and instruments allow an earlier initial activation of the processor within 14 days after surgery. Objective: Evaluation of the early CI device activation after CI surgery within 14 days, comparison to the first activation after 4–6 weeks, and assessment of the feasibility and safety of the early fitting over a 12 month observation period were the objectives of this study. Method: In a prospective study, 127 patients scheduled for CI surgery were divided into early fitting group (EF, n = 67) and control group (CG, n = 60). Individual questionnaires were used to evaluate medical and technical outcomes of the EF. Medical side effects, speech recognition, and follow-up effort were compared with the CG within the first year after CI surgery. Results: The early fitting was feasible in 97% of the EF patients. In the EF, the processor was activated 25 days earlier than in the CG. No major complications were observed in either group. At the follow-up appointments, side effects such as pain and balance problems occurred with comparable frequency in both groups. At initial fitting, the EF showed a significantly higher incidence of medical minor complications (p < 0.05). When developing speech recognition within the first year of CI use, no difference was observed. Furthermore, the follow-up effort within the first year after CI surgery was comparable in both groups. Conclusions: Early fitting of the sound processor is a feasible and safe procedure with comparable follow-up effort. Although more early minor complications were observed in the EF, there were no long-term wound healing problems caused by the early fitting. Regular inspection of the magnet strength is recommended as part of the CI follow-up since postoperative wound swelling must be expected. The early fitting procedure enabled a clear reduction in the waiting time between CI surgery and initial sound processor activation.

Endoscopy-assisted removal of periorbital inclusion cysts in children

2011 ◽  
Vol 7 (2) ◽  
pp. 161-164 ◽  
Author(s):  
George Chater-Cure ◽  
Caitlin Hoffman ◽  
Jared Knopman ◽  
Samuel Rhee ◽  
Mark M. Souweidane
Keyword(s):  
High Speed ◽  
Complete Removal ◽  
Skin Incision ◽  
Clinical Findings ◽  
Complete Excision ◽  
Alternative Approach ◽  
Cyst Recurrence ◽  
Scalp Incision ◽  
Access Technique

Object Surgical treatment for periorbital inclusion cysts typically involves a brow, pterional, or partial bicoronal scalp incision for sufficient exposure. The authors have recently employed an endoscopy-assisted technique as an alternative approach intended to minimize the length of the skin incision and avoid scarring in the brow. Methods Children having typical clinical findings of a dermoid cyst located on the hairless forehead were selected to undergo endoscopy-assisted cyst removal. For suspected intradiploic lesions, MR imaging was used to assess osseous involvement. After induction of general anesthesia, a 1–2-cm curvilinear incision was made posterior to the hairline. A 30°-angled endoscope (4 mm) was then used for dissection in the subgaleal compartment. Subgaleal dissection was followed by a circumferential periosteal incision in which the authors used an angled needle-tip unipolar cautery. For lesions within the diploe, a high-speed air drill was used to expose the lesion. Complete removal was accomplished with curettage of either the skull or dural surface. Results Eight patients (5–33 months of age) underwent outpatient endoscopic resection. Seven cysts were extracranial, and 1 cyst extended through the inner table. In all patients complete excision of the cyst was achieved. There was negligible blood loss, no dural violation, and no postoperative infection. There have been no recurrences at a mean follow-up of 15 months. Conclusions Endoscopy-assisted resection of inclusion cysts of the scalp and calvaria is a safe and effective surgical approach. The technique results in negligible incisions with less apparent scarring compared with previously described incisions. This limited-access technique does not appear to be associated with a higher incidence of cyst recurrence.

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