{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T08:45:49Z","timestamp":1764319549638,"version":"3.46.0"},"reference-count":37,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objective: Cesarean scar pregnancy (CSP) represents a challenging and potentially life-threatening form of ectopic pregnancy. This study aims to assess the feasibility, safety, and clinical efficacy of employing the hysteroscopic mechanical tissue removal system as a primary treatment modality for CSP. Methods: This retrospective cohort study included 53 patients diagnosed with CSP who underwent primary hysteroscopic resection at a tertiary care center. The surgical procedure was performed by prioritizing the \u201cno-touch\u201d vaginoscopic approach, which avoids instrumentation. Success rates, operation time, time to negative serum \u03b2-hCG, complications, and differences between the anatomical types of CSP (Type 1 vs. Type 2) were analyzed. Results: Primary hysteroscopic treatment was successful in 51 of 53 patients (96.2%). For the entire cohort, the median operative time was 7 min (range: 2\u201330), and the median interval to \u03b2-hCG negativization was 11 days (range: 6\u201345). The overall major complication rate was 3.8% (n = 2). One case was deemed unsuccessful due to conversion to laparotomy following uterine perforation during cervical dilation. Another patient, diagnosed with persistent trophoblastic disease requiring methotrexate (MTX) therapy, was also considered a treatment failure. Operative time was significantly longer in patients with Type II CSP compared with Type I (median 9 min vs. 5 min; p = 0.0004). Conclusions: Hysteroscopic mechanical tissue removal as a primary treatment for cesarean scar pregnancy represents an effective and safe \u201cone-step\u201d approach, characterized by a high success rate, rapid \u03b2-hCG resolution, and a low incidence of complications. This fertility-preserving, minimally invasive technique may be considered a primary treatment option for hemodynamically stable patients with CSP, provided that appropriate patient selection is undertaken and sufficient surgical expertise is available.<\/jats:p>","DOI":"10.3390\/diagnostics15233030","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T08:26:57Z","timestamp":1764318417000},"page":"3030","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Single-Session No-Touch Hysteroscopic Mechanical Resection for Cesarean Scar Pregnancy: A Novel Primary Treatment Approach"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1791-7523","authenticated-orcid":false,"given":"Cihan","family":"Bademkiran","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Diyarbakir Gazi Yasargil Research and Training Hospital, 21010 Diyarbakir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5300-6536","authenticated-orcid":false,"given":"Kevser","family":"Arkan","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Diyarbakir Gazi Yasargil Research and Training Hospital, 21010 Diyarbakir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8862-5328","authenticated-orcid":false,"given":"Mehmet","family":"Yaman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Diyarbakir Gazi Yasargil Research and Training Hospital, 21010 Diyarbakir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ihsan","family":"Bagli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Diyarbakir Gazi Yasargil Research and Training Hospital, 21010 Diyarbakir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet","family":"Obut","sequence":"additional","affiliation":[{"name":"Division of Perinatology, Department of Obstetrics and Gynecology, Memorial Diyarbakir Hospital, 21070 Diyarbakir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mesut","family":"Bala","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Diyarbakir Gazi Yasargil Research and Training Hospital, 21010 Diyarbakir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1100-0113","authenticated-orcid":false,"given":"Mesut Ali","family":"Haliscelik","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Diyarbakir Gazi Yasargil Research and Training Hospital, 21010 Diyarbakir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammed Hanifi","family":"Bademkiran","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Gaziantep University, 27410 Gaziantep, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pelin","family":"Bademkiran","sequence":"additional","affiliation":[{"name":"English Program, Faculty of Medicine, Biruni University, 34015 Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1016\/S0140-6736(18)31928-7","article-title":"Global epidemiology of use of and disparities in caesarean sections","volume":"392","author":"Boerma","year":"2018","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Betr\u00e1n, A.P., Ye, J., Moller, A.B., Zhang, J., G\u00fclmezoglu, A.M., and Torloni, M.R. 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