What is Hysteroscopy & used for?
Hysteroscopy is a procedure that involves insertion of a narrow telescope-like instrument through the vagina and cervix into the cavity of the uterus (endometrial cavity). The uterine cavity is then distended with fluid and visualized.
This procedure allows us to see if there are any uterine cavity defects such as :
- Fibroid tumors
- Endometrial polyps
- Intrauterine scar tissue
- A bicornuate uterus or septate uterine malformation
- Other uterine problems
- In failed IVF cycle for any uterine pathology
What problems can defects of the uterine cavity cause?
Abnormalities of the endometrial cavity can be responsible for infertility , excessive bleeding and painful menstrual cycles or problems with recurrent miscarriage.
The Endoscopy theatre at Aarush IVF & Endoscopy Centre is also equipped with bipolar hysteroscopic devices which are very safe for the patient during Hysteroscopic surgeries. Also smaller diameter hysteroscope (2.9mm) aids in effective visualisation of the uterine cavity in infertile patients without causing any injury to tissues.
What Is Laparoscopy?
Laparoscopy is a surgical procedure that involves making two to three very small cuts in the abdomen, through which the doctor inserts a laparoscope and specialized surgical instruments. A laparoscope is a thin, fiber-optic tube, fitted with a light and camera.
Laparoscopy allows to see the abdominal organs and sometimes make repairs, without making a larger incision that can require a longer recovery time and hospital stay.
We provide all kinds of Hysteroscopy and Laparoscopy facilities in house. The endoscopy theater is unique with the latest system of 3 chip HD Storz camera and all operative ancillary instruments. Many times infertility patients are subjected to diagnostic scopic procedures and it may not be possible to diagnose few conditions pre-operatively. A live relay system is available by which the ongoing procedure is relayed to the viewing room where the relatives can watch the procedure and also discuss with the doctor the remedial measures which can be carried out in the same sitting and patient doesn’t have to undergo a repeat surgery .
The Laparoscopic instrumentations are specifically designed for infertile patients like the use of small size 5 mm laparoscope and 3 mm graspers for diagnostic cases, harmonic device which can cut tissues with minimal side spread injury.
Check out what our patients got to say regarding the Endoscopy Services
Mrs.S was referred by her family physician for Infertility. Her ultrasound showed uterine fibroids ,with the largest one occupying major part of the uterine cavity. She underwent Hysteroscopic removal of the fibroid. Healing was complete and further conceived with medical treatment.
As Mrs.Savita underwent endometrioma removal laparoscopically. As the endometriosis was advanced and accompanied with low reserve and low sperm counts of husband she underwent ICSI cycle which resulted in conception.
Abnormalities of the endometrial cavity can be responsible for infertility , excessive bleeding and painful menstrual cycles or problems with recurrent miscarriage.
The technique of hysteroscopy has also been expanded to include operative hysteroscopy. Operative hysteroscopy can treat many of the abnormalities found during diagnostic hysteroscopy at the time of diagnosis. The procedure is very similar to diagnostic hysteroscopy except that operating instruments such as scissors, biopsy forceps, electrocautery instruments, and graspers can be placed into the uterine cavity through a channel in the operative hysteroscope. Fibroid tumours, scar tissue (synechiae or adhesions), and polyps can be removed from inside the uterus. Congenital abnormalities, such as a uterine septum, may also be corrected through the hysteroscope.
Endometrial or uterine polyps are soft, fingerlike growths which develop in the lining of the uterus (the endometrium). They develop because of excessive multiplication of the endometrial cells, and are hormonally dependent. They can usually be detected on an ultrasound scan if this is done mid-cycle. Polyps are an important cause of infertility, and they can easily be removed during hysteroscopic surgery.
A relatively new method for treating proximal tubal obstruction (cornual blocks, where the tubes are blocked at the utero-tubal junction) is that of hysteroscopic tubal cannulation. Many studies have shown that this kind of block is often because of mucus plugs or debris which plug the tubal lining at the uterotubal junction which is as thin as a hair. It is now possible to pass a fine guidewire through the hysteroscope into the tubes, and thus remove the plug or debris and open the tubes – thus restoring normal tubal patency with minimally invasive surgery.
Generally, laparoscopy should be reserved for couples who have already completed a more basic infertility evaluation including hormone investigations , assessing for ovulation, ovarian reserve , ultrasound for the female and semen analysis for the male. Some couples may elect to skip laparoscopy in favor of proceeding to other fertility treatments such as superovulation with fertility medications combined with intrauterine insemination or in vitro fertilisation. There may be instances where there is high suspicion for finding problems with laparoscopy for instance, if a woman had a history of a severe pelvic infection or a ruptured appendix, this would increase the likelihood that she may have pelvic adhesions and therefore more likely to benefit from early laparoscopy.