Diagnostic / Operative Laparoscopy
This procedure is done as daycare and requires a short anesthesia. During the procedure a 2mm incision is made in the umbilicus (navel) following which a telescopic instrument is introduced to view the internal organs. It is aided by the introduction of carbon dioxide gas to inflate the abdomen. We do it to assess the condition of the uterus, fallopian tubes and ovaries and adnexal regions.
It is useful in ruling out common pathologies, enabling a clear diagnosis and prompt treatment. The patency of the fallopian tubes which is very important for conception is also assessed simultaneously. When gross pathological conditions are discovered whose correction will enable better chances at fertility, operative laparoscopy can be carried out. The different procedures that can be performed range from removal of simple adhesions to removal of fibroids and ovarian cysts. The advantages include speedy recovery and shorter hospital stay. It may involve introduction of 2 or more side ports via skin incisions for performance. |
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Diagnostic / Operative Hysteroscopy
This is a daycare procedure which requires a short anesthesia. It can be performed alone or when indicated, in combination with a diagnostic laparoscopy. It involves the introduction of a similar telescopic instrument (hysteroscope) via the cervix (mouth of the uterus) in order to be able to visualize the entire cavity of the uterus which is the site of implantation of the embryo during conception.
During this procedure one can identify small polyps (fleshy outgrowths of the endometrium), fibroids (benign tumors of the muscular layer of the uterus), and any uterine abnormalities like a double uterus or a fleshy growth dividing the cavity into two halves, otherwise known as septum. Also one can visualize the normal openings of the fallopian tubes, known as ostia, where they communicate with the uterine cavity. This procedure also requires the use of a distension medium and we normally use saline. When identifiable pathology exists we perform excision procedures at the same sitting or at a later date for example Polypectomy, hystersocopic myomectomy and septum resection etc. |
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Endometrial Biopsy / Curettage
This is a simple procedure done to retrieve a sample of the endometrium (lining of the uterine cavity) for purpose of testing for pathology, especially in cases of abnormal uterine bleeding. It may be done as an office procedure or using a short anesthetic in those cases where there is difficulty in negotiating the cervix which precludes retrieval of an adequate sample. It is also performed as a part of the diagnostic laparoscopy/hysteroscopy to assess the phase of the uterine cycle. Most often a fractional curettage is performed prior to hysterectomy (removal of the uterus, tubes and ovaries) whereby samples are obtained from both the endocervix and the endometrium.
http://www.webmd.com/hw/healthy_women/hw4583.asp
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