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Chapter-43 Advanced Operative Office Hysteroscopy - 2010

BOOK TITLE: State of the Art Atlas of Endoscopic Surgery in Infertility and Gynecology

Author
1. Bettocchi Stefano
2. Nappi Luigi
3. Ceci Oronzo
ISBN
9788184489903
DOI
10.5005/jp/books/11190_43
Edition
2/e
Publishing Year
2010
Pages
13
Author Affiliations
1. Dipartimento di Scienze Chirurgiche Generali e Specialistiche Sezione di Ginecologia ed Ostetricia “A” Università degli Studi - Policlinico Piazza Giulio Cesare, University of Bari Bari, Italy, University of Bari, Bari, Italy, University of Bari Medical School, Italy
2. Sciences-Institute of Obstetrics and Gynecology II, University of Bari Bari, Italy, University of Bari Bari, Italy, University of Bari, Bari, Italy
3. University of Bari Bari, Italy, University of Bari, Bari, Italy
Chapter keywords

Abstract

Since the beginning of the 80s, hysteroscopy has proved to be a powerful diagnostic tool for visualizing the cervical canal and the uterine cavity. It yields better results than DandC and it can also be considered an excellent surgical aid in the treatment of endouterine pathologies with the use of the resectoscope. However, the two procedures, diagnostic and operative, have long been considered separate entities, as they required different instruments and a different approach to the patient. Since the introduction at the beginning of the 90s of new scopes with a diameter ranging between 1.2 and 3 mm, it has been possible to produce not only very thin diagnostic sheaths, but also operative sheaths with a diameter less than 5 mm. This has allowed us to perform, simultaneously during the same procedure, diagnosis and treatment of most benign endouterine pathologies without any premedication or anesthesia, reserving the use of the resectoscope and the operative theatre to a few, particular cases. By so doing hysteroscopy has achieved the goal of becoming an outpatient diagnostic and therapeutic procedure that is easily practicable even by beginners, confining resectoscopic procedures for selected cases to be treated by operators with the necessary experience.

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