This video demonstrates hysteroscopic management of retained products of conception following miscarriage in a patient with a history of recurrent pregnancy loss.

Initial hysteroscopy reveals substantial retained tissue obscuring the uterine cavity, with suspected synechiae not appearing to be the principal cause of obstruction.

The surgeon performs suction evacuation to remove the bulk of the retained tissue before reassessing the cavity hysteroscopically.

A significant technical challenge is inadequate uterine distension due to cervical saline leakage, which is corrected using Allis forceps to improve cervical sealing.

Once visualization improves, both tubal ostia are identified and residual tissue is localized.

The surgeon demonstrates resectoscopic removal under direct vision, initially using the loop mechanically without electrical current, followed by selective energy application for more adherent tissue.

The procedure concludes with reassessment of the uterine cavity and removal of the remaining suspected retained products.