Minimal Invasive Surgery

Hysteroscopy

ALL ABOUT HYSTEROSCOPY
Hysteroscopy uses a hysteroscope, which is a thin telescope that is inserted through the cervix into the uterus.  Modern hysteroscopes are so thin that they can fit through the cervix with minimal or no dilation.  Although hysteroscopy dates back to 1869, gynecologists were slow to adopt hysteroscopy.  Because the inside of the uterus is a potential cavity, like a collapsed air dome, it is necessary to fill (distend) it with either a liquid or a gas (carbon dioxide) in order to see.  Diagnostic hysteroscopy and operative hysteroscopy can usually be done in an outpatient setting.   

View through a hysteroscope

This is a view through a hysteroscope during  hysteroscopy of the inside of a uterus with two fibroids (myomas) on the back wall.  The upper portion of the photograph shows the top of the uterus, which is normal.  Fibroids like this can cause severe cramping (dysmenorrhea), heavy menstrual periods (menorrhagia) and bleeding between periods (metrorrhagia.) These fibroids were quickly and accurately diagnosed by hysteroscopy.

These myomas can be removed using a special kind of hysteroscope called a resectoscope.

This photograph also taken during  hysteroscopy shows a polyp in the lower part of the uterus.  This type of polyp often causes bleeding between periods and is easily removed. Office sonohysterogram can often diagnose these thereby allow quick and accurate diagnosis of the cause of abnormal bleeding.

The polyp was removed by simple operative hysteroscopy or endometrial ablation.

WHAT IS OPERATIVE HYSTEROSCOPY?
During diagnostic hysteroscopy the hysteroscope is used just to observe the endometrial cavity (inside of the uterus).  During operative hysteroscopy a type of hysteroscope is used that has channels in which it is possible to insert very thin instruments.  These instruments can be used to remove polyps, to cut adhesions, and do other procedures.  With the development of better and smaller instruments, there is less trauma to the cervix and patients are able to tolerate these procedures in an outpatient surgery center. Patients are able to return to there normal activities quickly and require very short recovery periods.  In many situations, operative hysteroscopy may offer an alternative to hysterectomy.

©2007 Women's Associates, P.C.