Pictures of the whole process of hysteroscopy

Hysteroscopy is a new, minimally invasive gynecological treatment technology, a fiber-light-emitting electronic endoscope used for regular inspection and treatment of the uterus. It includes a hysteroscope, a power supply, a light source system, a perfusion system and an imaging system; it uses the front side of the scope to enter the uterine cavity, which has the effect of magnifying the observed area, and becomes the preferred inspection method for gynecological exudative diseases and intrauterine diseases in a visual and accurate manner. Through hysteroscopy, women are examined, diagnosed, analyzed and undergo a series of tests and treatments. So what are the steps of hysteroscopic surgery? The following is a detailed introduction to the entire process of hysteroscopic surgery

1. Inspection time

The best time for hysteroscopic surgery is within 1 week after menstruation, that is, the early, middle and late stages of the proliferative phase of the menstrual cycle. Other times should be chosen when necessary.

2. Anesthesia and Analgesia

Simple examinations can be performed with local anesthesia and analgesics, such as 50 mg of pethidine intramuscular injection, 1% lidocaine 10 mL of paracervical nerve block anesthesia, etc. Propofol can also be used for general anesthesia given intravenously.

3. Surgical treatment process

1. Complete preoperative counseling, inform the subjects and sign the informed consent.

2. Avoid eating before surgery, put the bladder in lithotomy position, and perform basic gynecological disinfection on the private parts, vagina, cervix, and cover with disinfectant towels.

3. Use the cervical forceps to clamp the anterior lip of the cervix, explore the deep layer of the uterine cavity, and dilate the cervix to a size that is half the diameter of the outer sheath of the hysteroscope.

4. Connect the hysteroscope to the TV camera, light source, and uterine expansion system. The bubbles in the uterine distension fluid are expelled, and the hysteroscope is slowly inserted into the uterine cavity while distending the uterus. A detailed examination of the uterine cavity was performed in the order of the uterine fundus, four walls, uterine cornu, bilateral fallopian tube openings, internal cervical opening, and cervical canal.

5. If you need to take a living thing, you can use small forceps to accurately locate the sample through the operating hole.

4. Normal uterine cavity image

When the uterus is well dilated, the fundus of the uterus expands, and sometimes it can be seen that the fundus bulges slightly inward, so that the uterine corners on both sides appear deeper. The uterine wall mirror system undergoes certain changes with the menstrual cycle.

1. During the reproductive period, the endometrium is smooth, reddish-yellow; in the middle and late stages of hyperplasia, the endometrium may have localized wavy protrusions or cystic shapes; sometimes the blood vessels can be clearly seen; the bilateral fallopian tube openings are easy to see, but are relatively small and covered by secretions.

2. During the metabolic period, the endometrium thickens and becomes uneven, with a cystic, wavy, and flocculent surface, often accompanied by floating mucus; the shape of the blood vessels is not easy to see; the openings of the bilateral fallopian tubes are not easy to see.

3. After menopause, the endometrium is thin, smooth and flat, and spots or scattered bruises can be seen.

4. The endometrium of the cervical canal is reddish yellow, smooth, and has vertical rows of wrinkles

5. The bilateral fallopian tube openings are mostly bright round pits or pupil-shaped, or super black holes or chloasma-like, which is related to the timing of surgical treatment and the actual effect of uterine dilation.

6. Other mirror systems often show suspended mucus, mucosal debris, bleeding and bubbles.

5. Abnormal uterine cavity image

1. Foreign bodies in the uterine cavity, such as ruptured or residual contraceptive rings, fetal bone fragments, may be partially covered by the mucous membrane and mucus.

2. Intrauterine adhesions Various forms of intrauterine adhesions.

3. Abnormal uterus such as saddle-shaped, double-horned and uterine septate.

4. Blood spots, bruises or bleeding.

5. The shrinkage and fibrosis process is pale, smooth, with few blood vessels, or with bruises.

6. Hypertrophy is uneven, edematous, thickened, and has increased secretions.

7. The cysts are smooth, soft, white or the same color as the endometrium, monocystic or multiple, with or without pedicles.

8. Uterine fibroids are white in color and have blood vessels on the surface.