Advanced operating system – TruClear® in BioCell

For the first time in Serbia, the Biocell Hospital team headed by prof. Dr. Aleksandr Ljubić used the TruClear® advanced hysteroscopic operating system for the treatment of various pathological changes in the uterine cavity

Operative hysteroscopy, or advanced operative system, is a minimally invasive gynecological operative procedure in which an optical system (camera) and appropriate instruments are introduced through the cervix into the uterine cavity. This is done in order to remove various pathological changes (fibroids, polyps, adhesions, partitions). The use of smaller optics made it possible for this intervention to be increasingly performed in outpatient settings. The classic approach to the treatment of various pathological changes in the uterine cavity was based on their removal using electrical thermal energy (resectoscopes) and mechanical (scissors).

Application of thermal energy, in addition to all the advantages it offers, always carries the potential risk of damaging the surrounding healthy tissue as well as perforation of the uterine wall. Despite the fact that these complications are relatively rare, there was a need to introduce new technologies in order to overcome these shortcomings.

In 1999, Dr. Mark Hans Emanuel, a gynecologist from Utrecht in the Netherlands, constructed the first generation of instruments intended for hysteroscopic removal of changes from the uterine cavity. They operate on a mechanical principle unlike most other instruments that use electricity. Over time, more of these systems have become available. One of the most modern is the TruClear® (Medtronic, Dublin, Ireland) system. The team of Prof. Dr. Aleksandra Ljubića, for the first time in Serbia at Biocell Hospital General Hospital, performed the procedure using the TruClear® system, which is now available at Biocell for patients who are indicated for hysteroscopic intervention.

This system uses mechanical energy to simultaneously cut and aspirate tissue. Experience from clinical practice over the past years has shown that the TruClear® system is a safe and effective minimally invasive alternative to classic operative hysteroscopy in the treatment of uterine pathology such as endometrial polyps, fibroids and residual placental tissue after childbirth or termination of pregnancy.
Bearing in mind the fact that with the TruClear® system tissue removal is performed mechanically and not thermally, the patient’s painful sensations are less compared to classic hysteroscopic resectoscopy. This provides the possibility to use this system in ambulatory conditions under local anesthesia. The mechanical principle of tissue removal in the TruClear® system reduces the risk of damaging the surrounding healthy tissue, which is normally present when using thermal electricity. Residual placental tissue after childbirth or termination of pregnancy is one of the complications traditionally treated with curettage. This intervention, however, carries the risk of complications such as superforation, infection and the formation of adhesions within the uterine cavity (Pacheco et al., 2019).

Using the TruClear® system, it is possible to directly remove residual placental tissue under camera control without the risk of damaging the surrounding uterine mucosa and creating intrauterine adhesions (Ansari et al., 2018). This is just one of the innovations that Biocell Hospital made possible for female patients in Serbia and thus continued with its mission to make the most modern medical techniques and procedures performed in the world available in our country. The desire of the Biocell Hospital team is for modern technologies to be at the service of patients in Serbia, and for this purpose a partnership has been concluded with the world’s leading manufacturers of the most modern medical equipment and devices.