Uterine pathologies within the cavity of the uterus can be dealt with using hysteroscopy
These procedures are mostly completed in a day care setting (i.e. the patient goes back home the same day of the procedure). It requires a specialized team of anesthetists and staff members who are properly trained in fluid management and a surgeon who can complete the procedure as soon as possible.
Hysteroscopy involves filling the uterine cavity with fluid and using a telescope to visualize the cavity.
In this procedure, a hysteroscope with an operative sheet is introduced into the uterine cavity. Using a pair of hysteroscopic scissors and grasper, the polyp is first cut out, grasped and sent to the pathology department.
This procedure greatly increases implantation rates and also alleviates any excessive bleeding if any.
Fibroids in the uterus can extend into the uterine cavity called submucous fibroids. Depending on the extent of protrusion within the cavity they are 3 grades, grade 0, 1 & 2.
In this procedure a specialized instrument called the resectoscope is introduced into the uterine cavity. Using the vaporizing and cutting property of monoploar current , the fibroid is completely resected out piecemeal (in tiny pieces).This procedure greatly increases implantation rates and alleviates excessive bleeding.
Hysteroscopic septal resection
Congenital malformations are sometimes present in couples trying to conceive. Most of these defects (unless there is a complete absence of the uterus) can be corrected endoscopically. One such malformation is the uterine septum, in which the uterus is partitioned by a thin septum in the center. This septum can be resected using the resectoscope (fitted with a Colin’s knife). This procedure greatly enhances the changes of conception.
Trans Cervical Resection of Endometrium
TCRE is an extremely skilled procedure that requires the complete removal of the lining of the endometrium. This procedure is usually done for patients with excessive bleeding, but want to conserve the uterus. Pregnancy will not occur after this procedure and its essential that an intrauterine contraceptive device be placed in the uterus after the surgery.