Extracorporeal sliding knot technique for simplified hysteroscopic suture fixation of levonorgestrel-releasing intrauterine device

The authors aimed to simplify the hysteroscopic suture fixation technique for levonorgestrel-releasing intrauterine devices (LNG-IUDs) to improve its adoption in clinical practice, particularly for women with adenomyosis at risk of expulsion. They developed an optimized extracorporeal sliding knot method that reduces technical complexity and eliminates the need for repeated instrument exchanges, while maintaining the efficacy of the original technique. This innovation enhances the reproducibility and accessibility of the procedure for broader use.