General knowledge of hysteroscopic surgery

Although the uterine cavity is a small space, various lesions may exist, such as endometrial polyps, submucosal fibroids, endometrial cancer, longitudinal septum, uterine adhesions, placental implantation, placental remnants, and so on. There are both benign and malignant lesions. Many women do not know enough about intrauterine lesions and are often overburdened. Many physicians may also have some doubts and misunderstandings when identifying, localizing and treating lesions. For example, in the past, for the non-detached submucosal fibroids, abnormal organisms in the uterine cavity or residual foreign bodies in the uterine cavity, some physicians have arbitrarily resorted to surgical removal of the entire uterus. The invention and use of hysteroscopy has changed this phenomenon. First, what is hysteroscopy? Hysteroscopes can be categorized into panoramic hysteroscopes, contact hysteroscopes, and microscopic hysterosalpingoscopes. In addition, hysteroscopes can be categorized into examination and surgical scopes. The general process of examination by hysteroscopy is as follows: firstly, the uterine cavity is opened by starting the uterine cavity irrigation system, and then a lens connected with a miniature camera is put in to observe the uterine cavity while entering the uterine cavity, and the image taken by the lens is transmitted to the TV screen, through which the doctor can clearly observe the situation inside the cervical canal and the uterine cavity. Second, what is the use of hysteroscopy? Through hysteroscopy, it can not only determine the location, size, appearance and scope of lesions in the uterine cavity, but also observe the tissue structure on the surface of the lesions in detail, and carry out biopsy and localization scraping under the direction of hysteroscopy, which improves the accuracy of the diagnosis of the diseases in the uterine cavity, and makes up for the deficiencies of the traditional diagnostic methods. More importantly, hysteroscopy plays an important role in detecting endometrial cancer, especially when the cancer is limited to the surface of mucosa. How does hysteroscopic surgery reflect the concept of “minimally invasive”? The development of hysteroscopic surgery enables many patients who need to remove the uterus by traditional methods to avoid open surgery and preserve the uterus. In recent years, with the development of hysteroscopic technology, the application of microscopic uterine colposcopy for young girls, unmarried women and women with cervical stenosis of the vagina, cervix and uterine cavity of the lesions of the new means of diagnosis and treatment, and more enhance its status in the minimally invasive gynecological surgery. What are the indications for hysteroscopic surgery? Not all uterine diseases are suitable for hysteroscopic surgery. The indications for hysteroscopic surgery can be divided into three categories: (1) Optimal indications include dysfunctional uterine bleeding, endometrial polyps, submucosal fibroids, uterine adhesions, intrauterine foreign bodies and uterine malformations. (2) General indications include infertility, early-stage submucosal fibroids, ectopic pregnancy, and tubal sterilization or combination with other minimally invasive treatments. (3) Relative indications include hysteroscopic surgery for difficult uterine fibroids, such as type II submucosal fibroids with a diameter greater than 5 cm or multiple uterine submucosal fibroids, myometrial intrauterine device fragment residue, and endometrial atypical hyperplasia.