Hysteroscopical excision can be done for all EXCEPT:
**Core Concept**
Hysteroscopic excision is a minimally invasive surgical procedure used to remove lesions or growths within the uterine cavity. This technique is particularly useful for managing conditions that arise from the endometrium or the submucosal layer of the myometrium. The procedure involves the insertion of a hysteroscope through the cervix, allowing for direct visualization of the uterine cavity.
**Why the Correct Answer is Right**
Subserous fibroids, also known as subserosal fibroids, grow from the outer surface of the uterus. Since they are located outside the uterine cavity, hysteroscopic excision is not an appropriate treatment option for subserous fibroids. Hysteroscopy is limited to visualizing and accessing lesions within the uterine cavity, making it unsuitable for subserous fibroids.
**Why Each Wrong Option is Incorrect**
**Option A:** Uterine fundus fibroids can be submucosal or intramural, and some may be accessible for hysteroscopic excision, depending on their exact location and size.
**Option B:** Submucous fibroids project into the uterine cavity and can be effectively treated with hysteroscopic excision.
**Option D:** Endometrial polyps are a type of growth that arises from the endometrium and can be removed through hysteroscopic excision.
**Clinical Pearl / High-Yield Fact**
When considering hysteroscopic excision, it is essential to differentiate between submucosal and intramural fibroids, as the latter may not be accessible for this procedure. A thorough preoperative evaluation, including imaging studies and hysterosalpingography, is crucial in determining the appropriateness of hysteroscopic excision for each patient.
**✓ Correct Answer: C. Subserous fibroid**