Just as with a standard hysteroscope, the resectoscope is inserted through the cervix.  Because it goes through the cervix,  it is not necessary to make an incision.   Procedures using the resectoscope are done in an operating room setting, such as in an outpatient surgery center.  This can at times be done under local anesthesia, but most women prefer to be completely asleep with general anesthesia. 

The resectoscope is far more efficient at removing tissue (such as fibroids or large polyps) than conventional instruments.   Because of this, the resectoscope should be used only by physicians who have training in its use and who use it on a regular basis.

 View through the resectoscope of actual removal of fibroid

We are looking in the uterus through a resectoscope.  We can see a large fibroid filling the uterine cavity.  The cutting loop of the resectoscope has been placed beyond the fibroid, and is getting ready to cut out a piece of fibroid.  The pieces are removed through the cervix. 

The fibroid has been entirely removed.  The uterine cavity, which had been hidden by the fibroid, can now be seen.  (The loop looks larger in this photo because it is closer to the lens.)