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Tumor Therapy China

Hysteroscopic Surgery For Fibroids/Polyps/Septum

If you are considering hysteroscopic surgery for fibroids/polyps/septum in China and would like to get know more information about hysteroscopic surgery for fibroids/polyps/septum, please complete the inquiry form or email us at info@shmtppp.com

Overview

Hysteroscopy is a minimally-invasive surgical procedure that can be used to remove certain types of fibroids, Polyps and Septum without difficulty. The surgery involves placing a small telescope instrument within the uterine cavity and examining the cavity.

Procedures

Hysteroscopy has been done in the hospital, surigal centers and the office. It is best done when the endometrium is relatively thin, that is after a menstruation. Typically hysteroscopic intervention is done under general endotracheal anesthesia or Monitored Anesthesia Care (MAC), but a short diagnostic procedure can be performed with just aparacervical block using the Lidocaine injection in the upper part of the cervix. The patient is in a lithotomy position.

After cervical dilation, the hysteroscope with its sheath is guided into the uterine cavity, the cavity insufflated, and an inspection is performed. If abnormalities are found, an operative hysteroscope with a channel to allow specialized instruments to enter the cavity is used to perform the surgery. Typical procedures include endometrial ablation, submucosal fibroid resection, and endometrial polypectomy. Hysteroscopy has also been used to apply the Nd:YAG laser treatment to the inside of the uterus.

When fluids are used to distend the cavity, care should be taken to record its use (inflow and outflow) to prevent fluid overload and intoxication of the patient.

Indications

Hysteroscopic Surgery

Hysteroscopy is useful in a number of uterine conditions:

  • Asherman's syndrome (i.e. intrauterine adhesions). Hysteroscopic adhesiolysis is the technique of lysing adhesions in the uterus using either microscissors (recommended) or thermal energy modalities. Hysteroscopy can be used in conjunction with laparascopy or other methods to reduce the risk of perforation during the procedure.
  • Endometrial polyp Polypectomy
  • Gynecologic bleeding
  • Endometrial ablation (Some newer systems specifically developed for endometrial ablation such as the Novasure do not require hysteroscopy)
  • Myomectomy for uterine fibroids
  • Congenital Uterine malformations (also known as Mullerian malformations). Eg.septum
  • Evacuation of retained products of conception in selected cases
  • Removal of embedded IUDs

The use of hysteroscopy in endometrial cancer is not established as there is concern that cancer cells could be spread into the peritoneal cavity.

Hysteroscopy has the benefit of allowing direct visualization of the uterus, thereby avoiding or reducing iatrogenic trauma to delicate reproductive tissue which may result inAsherman's syndrome.

Hysteroscopy allows access to the utero-tubal junction for entry into the fallopian tube; this is useful for tubal occlusion procedures for sterilization and for falloposcopy.

Complications

A possible problem is uterine perforation when either the hysteroscope itself or one of its operative instruments breaches the wall of the uterus. This can lead to bleeding and damage to other organs. If other organs such as bowel are injured during a perforation, the resulting peritonitis can be fatal. Furthermore, cervical laceration, intrauterine infection (especially in prolonged procedures), electrical and laser injuries, and complications caused by the distention media can be encountered. The use of insufflation media can lead to serious and even fatal complications due to embolism or fluid overload with electrolyte imbalances.

The overall complication rate for diagnostic and operative hysteroscopy is 2% with serious complications occurring in less than 1% of cases.

If you are considering hysteroscopic surgery for fibroids/polyps/septum in China and would like to get know more information about hysteroscopic surgery for fibroids/polyps/septum, please complete the inquiry form or email us at info@shmtppp.com