Hysterolaparoscopy

Hysteroscopy is a procedure that allows your doctor to look inside your uterus in order to diagnose and treat causes of abnormal bleeding, a thin lining of uterus (Endometrium), infertility cause, or any anatomical problem and also check the patency of Fallopian tube.

Laparoscopy is an operation performed in the abdomen and pelvis through a small incision  (usually 0.5–1.5 cm) with the aid of a camera. It can either be used to inspect and diagnose a condition or to perform surgery. Hyster laparoscopy is a combination procedure in which Hysteroscopy and Laparoscopy are performed in the same sitting. Hyster laparoscopy is more beneficial as the diagnosis of the problem and treatment can be done at the same sitting. This helps take the decision for artificial reproductive techniques during the evaluation itself (Vaid 2014).

Procedure -In a Hysteroscopic procedure doctor uses a thin viewing tool called a hysteroscope. The tip of the hysteroscope is put into your vagina and gently moved through the cervix into the uterus. The hysteroscope has a light and camera hooked to it so your doctor can see the lining (endometrium) on a video screen and laparoscopy allows doctors to perform both minor and complex surgeries with a few small cuts in the abdomen to visualize inside the abdominal cavity or to perform any surgical procedure.

Why It Is Done- 

Hysterolaparoscopy can be used for diagnosis, treatment, or both. A diagnostic procedure can sometimes turn into a treatment.

Some reasons for diagnostic  Hysterolaparoscopy are:

  • Find the cause of severe cramping or abnormal bleeding. Your doctor can pass heated tools through the hysteroscope to stop the bleeding.
  • See whether a problem in the shape or size of the uterus or if scar tissue in the uterus is the cause of infertility.
  • Look at the uterine openings to the fallopian tube. If the tubes are blocked, your doctor may be able to open the tubes with special tools passed through the hysteroscope.
  • Find the possible cause of repeated miscarriage. Other tests may also be done.
  • Find and remove a misplaced intrauterine device (IUD)
  • Find and remove small fibroid or polyps.
  • Check forendometrial cancer.
  • Use heated tools to remove problem areas in the lining of the uterus (endometrial ablation).
  • Place a contraceptive implant (such as Essure) into the opening of the fallopian tubes as a method of permanent sterilization
  • Unexplained pelvic pain
  • Unexplained infertility
  • A history of pelvic infection
  • Torsion Ovarian cyst
  • Simple or complex ovarian cyst
  • PID

Conditions that might be diagnosed using Hysterolaparoscopy include:

  • Endometriosis
  • Septated uterus
  • Blocked fallopian tube
  • Uterine fibroids
  • Ovarian cysts or tumors
  • Ectopic pregnancy
  • Pelvic abscess, or pus
  • Pelvic adhesions, or painful scar tissue
  • Infertility
  • Pelvic inflammatory disease
  • Reproductive cancers

How To Prepare

Tell your doctor if you:

  • Are or might be pregnant.
  • Are taking any medicines.
  • Are allergic to any medicines.
  • Have had bleeding problems or take blood-thinners, such as aspirin or warfarin).
  • Have been treated for a vaginal, cervical, or pelvic infection in the past 6 weeks.
  • Have any heart or lungs

Preparation

If the procedure is done in the hospital under general anesthesia, the patient should not eat or drink anything (not even water) after midnight the night before the procedure.

Aftercare

Many women experience light bleeding for several days after surgical hysteroscopy. Mild cramping or pain is common after operative hysteroscopy but usually fades away within eight hours. If carbon dioxide gas was used, there may also be some shoulder pain. Nonprescription pain relievers may help ease discomfort. Women may want to take the day off and relax after having a hysteroscopy.

Risks

Diagnostic hysteroscopy is a fairly safe procedure that only rarely causes complications. The primary risk is prolonged bleeding or infection, usually following surgical hysteroscopy to remove a growth. Very rare complications include perforation of the uterus, bowel, or bladder. Surgery under general anesthesia causes the additional risks typically associated with anesthesia.

Patients should alert their health care provider if they develop any of these symptoms:

  • abnormal discharge
  • heavy bleeding
  • fever over 101 °F (38.3°C)
  • severe lower abdominal pain