{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:17:26Z","timestamp":1791227846124,"version":"4.1.0"},"reference-count":10,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2012,5,28]],"date-time":"2012-05-28T00:00:00Z","timestamp":1338163200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2012,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare costs and complications associated with ultrasound\u2010guided hysteroscopy  <jats:italic>vs<\/jats:italic> laparoscopy\u2010guided hysteroscopy <jats:italic>vs<\/jats:italic> hysteroscopy alone for the surgical repair of intrauterine septa and synechiae.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study. Charts of all patients undergoing reparative surgery for intrauterine synechiae or uterine septa at our academic institution between 2000 and 2008 were reviewed. A total of 159 procedures were included in the study, categorized into concurrent laparoscopic guidance (<jats:italic>n<\/jats:italic> = 69), ultrasound guidance (<jats:italic>n<\/jats:italic> = 52) or no guidance (<jats:italic>n<\/jats:italic> = 38). Data regarding billing, surgical case logs and complications were collected for these procedures. Using these data, complication rates and inflation\u2010adjusted charges were compared between the groups. Statistical analysis was performed using Fisher's exact test and Student's <jats:italic>t<\/jats:italic>\u2010test, as appropriate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A uterine perforation rate of 8.7% was observed with laparoscopic guidance <jats:italic>vs<\/jats:italic> 1.9% with ultrasound guidance (<jats:italic>P<\/jats:italic> = 0.12) and 5.3% with no guidance (<jats:italic>P<\/jats:italic> = 0.41). Analysis of billing data showed that average total costs were significantly less for ultrasound guidance than for laparoscopic guidance ($9124 <jats:italic>vs<\/jats:italic> $11 895, <jats:italic>P<\/jats:italic> &lt; 0.001). Ultrasound guidance did not increase costs over hysteroscopy alone ($9124 <jats:italic>vs<\/jats:italic> $8242, <jats:italic>P<\/jats:italic> = 0.54).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Real\u2010time transabdominal ultrasound guidance during the resection of intrauterine synechiae or septa resulted in a trend towards reduced uterine perforation. Moreover, ultrasound guidance is less costly than laparoscopic guidance and adds no additional cost over hysteroscopy alone. Taken together, transabdominal ultrasound guidance is the optimal means of intraoperative guidance for the resection of uterine synechiae and septa. Copyright \u00a9 2012 ISUOG. 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L.","family":"Ryan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,5,28]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.grf.0000211948.36465.a6"},{"key":"e_1_2_5_3_2","first-page":"274","article-title":"Hysteroscopic metroplasty under laparoscopic guidance in infertile women with septate uteri: follow\u2010up of reproductive outcome","volume":"49","author":"Litta P","year":"2004","journal-title":"J Reprod Med"},{"key":"e_1_2_5_4_2","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/S0015-0282(16)54864-X","article-title":"Three\u2010contrasts method hysteroscopy: the use of real\u2010time ultrasonography for monitoring intrauterine operations","volume":"57","author":"Dabirashrafi H","year":"1992","journal-title":"Fertil Steril"},{"key":"e_1_2_5_5_2","first-page":"413","article-title":"Intraoperative ultrasound guidance for operative hysteroscopy. A prospective study","volume":"45","author":"Coccia ME","year":"2000","journal-title":"J Reprod Med"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1996.08020134.x"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)56963-5"},{"key":"e_1_2_5_8_2","first-page":"70","article-title":"Ultrasound controlled operative hysteroscopy","volume":"179","author":"Shalev E","year":"1994","journal-title":"J Am Coll Surg"},{"key":"e_1_2_5_9_2","first-page":"35","article-title":"Hysteroscopic lysis of intra\u2010uterine adhesions under ultrasound guidance","volume":"4","author":"Fraser IS","year":"1995","journal-title":"Gynaecol Endosc"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(87)90311-5"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(86)90180-8"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.11072","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.11072","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T16:38:04Z","timestamp":1700584684000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.11072"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,5,28]]},"references-count":10,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2012,6]]}},"alternative-id":["10.1002\/uog.11072"],"URL":"https:\/\/doi.org\/10.1002\/uog.11072","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,5,28]]},"assertion":[{"value":"2011-11-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-05-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}