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 airdome, it is necessary to fill (distend) it with either a liquid or a gas (carbon dioxide) in order to see. Diagnostic hysteroscopy and simple operative hysteroscopy can usually be done in an office setting. More complex operative hysteroscopy procedures are done in an operating room setting.
Operative Hysteroscopy is performed under general anesthesia. This will allow the physician to both diagnose and treat most findings, which are encountered at the time of the procedure. The Operative Hysteroscope has ports, which allow the physician to insert operating tools, such as, scissors, cautery devices or a laser fiber. These may be used to resect or cauterize specific abnormalities under direct visualization. The Hysteroscope is also valuable in treating some forms of tubal occlusion. Many patients with a blockage in the fallopian tube may have an obstruction at the junction between the uterus and fallopian tube. The Hysteroscope is used to pass a small catheter through this contracted area under direct visualization. Occasionally, scar tissue can be disrupted and allow passage of sperm as the result of the procedure. A physician will be able to evaluate the cervical canal, the contour of the uterus, and the quality of the endometrial lining. The tubal ostia are the openings of the fallopian tube into the uterine cavity. They should be easily seen with the hysteroscope
A diagnostic laparoscopy is a technique used by surgeons to obtain information about the inside of your abdomen without making a large incision. Through a few small incisions, the surgeon inflates the abdomen with gas (carbon dioxide) to enlarge the size of the viewing area. He or she then inserts a laparoscope or small camera which projects images of the abdomen onto a high resolution television screen. By mobilizing the camera, the surgeon can have a very thorough look through your abdomen without the pain and recovery of a larger incision. In most cases, this procedure provides the surgeon with more information about your condition than if routine tests were used.