Complications of hysteroscopy and how to avoid them

• Hysteroscopic surgery has specific risks due to the distension media and surgical technologies used.
• Large audits and national datasets demonstrate that hysteroscopic surgery is safe and effective; however, precise data on rare complications are still largely unknown.
• Most new technologies avoid the use of nonionic distension media and hence many of the complications of fluid overload.
• Although there are a variety of licensed global endometrial ablation devices available, no device has a clear margin in terms of safety or efficacy.

The advances in surgical technology such as bipolar electrosurgery, endometrial ablation devices, hysteroscopic sterilization, and morcellators have revolutionized this surgical modality. This article reviews the potential complications in hysteroscopic surgery and the means by which they may be minimized or avoided.