The "three mirrors" are hysteroscopy, laparoscopy and salpingoscopy, and the "trace" is the guide wire for tubal cooking.
Hysteroscopy: You can know the situation inside the uterus and whether there are polyps and adhesions in the uterine horn and fallopian tube interstitial part.
Laparoscopy: You can know the specific situation in the abdominal cavity, the tissue structure around the fallopian tube and whether there is adhesion.
Tuboscopy: It can check the normal epithelium and abnormal lesions of fallopian tubes and identify the causes of proximal tubal obstruction.
"A trace" is a technique used to dredge fallopian tubes.
KARL-STORL hysteroscopy equipment in Germany consists of a mirror body, a cold light source, a video image detection system, a camera system, a blower, a high-frequency surgery system, a thermal coagulation system and a washing absorption system. It is a high-tech diagnosis and treatment equipment in contemporary gynecological diagnosis and reproductive medicine. At present, this cutting-edge equipment has been widely used in the diagnosis and treatment of infertility in our hospital. Good curative effect has been achieved.
Hysteroscopy can be used for the following clinical examinations:
1. Examination of the causes of infertility: to know whether the intrauterine environment and the shape of the fallopian tube opening are normal, to observe the growth of endometrium, to check whether there are intrauterine adhesions, endometrial hyperplasia or endometrial polyps, submucous uterine fibroids, and to locate biopsy when necessary;
2. Evaluation of abnormal hysterosalpingography;
3. Intrauterine abnormalities indicated by B-ultrasound can be directly observed;
4. Check for abnormal uterine bleeding;
5. Explore the causes of recurrent spontaneous abortion;
6. Endometrial biopsy;
What is more valuable is that minimally invasive surgery can be performed at the same time as the above examination. The operations that can be performed include endometrial polypectomy, myomectomy, intrauterine adhesion separation, mediastinal resection, foreign body removal and so on.
Laparoscopic surgery is performed in a closed pelvic cavity and abdominal cavity. Under the irradiation of the cold light source, the camera system photographs the organs in the pelvic cavity and abdominal cavity on the monitoring screen through the laparoscope connected with the pelvic cavity and abdominal cavity, and the doctor manipulates the surgical instruments inserted into the pelvic cavity outside the abdominal cavity to directly look at the monitoring screen to check and treat the diseased tissues.
Laparoscopy can be used to examine and treat the following infertility:
1. Used for pelvic and abdominal examination of primary and secondary infertility, looking for the cause and assisting diagnosis and treatment;
2. Used for the diagnosis and treatment of tubal infertility, to understand the functional state of fallopian tube, separate adhesion, dredge fallopian tube, make umbrella end reconstruction opening, and restore peristalsis and egg collection functions;
3. It is used for the diagnosis and treatment of infertility due to ovulation disorder, such as the treatment of polycystic ovary syndrome and ovarian biopsy;
4. Used for early diagnosis, correct staging and focus removal of endometriosis;
5. Correct and suspend the backward uterus to make it return to normal;
6. Cooperate with hysteroscopy for operation;
7. Diagnosis of pelvic conditions before assisted pregnancy technique, laparoscopic egg retrieval and gamete tubal transplantation.
Using hysteroscopy and laparoscopy to treat infertility has the following advantages:
1. can be diagnosed and treated at the same time, which has the advantage of one step;
2. There is no need for abdominal surgery, and there is no scary scar on the abdomen. Just open a small hole of 0.5cm and adopt minimally invasive technology, which is advanced, safe, less painful, simple and fast;
3. Physical strength recovered quickly after operation, and normal life can be restored quickly;
4. No sequelae such as pain, adhesion and easy infection after traditional surgery.
Tuboscopy is a kind of endoscope, also called hard mirror, with a magnification of 80 times. It is difficult to enter the isthmus of fallopian tube further, because the diameter of fallopian tube is 2.5-2.8 mm ... In 1980s, hysteroscopy was successfully inserted through vagina and cervix, and the fallopian tube with an outer diameter of 0.8-2.0 mm was also called soft mirror, which reduced the damage to the mucosa of fallopian tube and the risk of fallopian tube perforation. On 1992, Kerin performed a non-hysteroscopic tubal examination. The fallopian tube catheter is introduced into the fallopian tube mouth through the uterine catheter with curved front end, and the salpingoscope is connected with the connector of the catheter.
Application of salpingoscope in diagnosis and treatment of infertility
Tubal disease is the main cause of female infertility, accounting for 30%-40%. There are many methods to check fallopian tubes, such as tubal ventilation, hysterosalpingography and laparoscopic fallopian tube drainage. These methods can only understand the course, patency and pelvic tissue adhesion of fallopian tubes, and belong to the examination of tubal anatomical function. Tuboscopy can observe the lumen epithelium of fallopian tube directly, understand its functional state, and provide a diagnosis and treatment plan for tubal infertility. This is the advantage of salpingoscopy, which other methods do not have. However, no method can have a comprehensive and accurate understanding of fallopian tubes, and each examination has its limitations. Tuboscopy combined with laparoscopy and hysterosalpingography may be the best choice to check the patency and functional status of fallopian tubes. Another use of salpingoscope is to locate gametophyte intubation or embryo transfer through hysteroscopy.
Tubal obstruction can also be treated with salpingoscope. For proximal tubal obstruction, coaxial catheter system can be used for recanalization. For the obstruction of the distal fallopian tube, salpingoscopy can accurately grasp the location and scope of fallopian tube lesions, evaluate the mucosal state of fallopian tube, thus providing a basis for the choice of treatment methods and predicting the therapeutic effect.
Compared with other gynecological endoscopes, although its operation is not complicated, its clinical application is limited because of its expensive equipment. However, with the development of reproductive medicine and the in-depth study of fallopian tubes, salpingoscopy will further show its advantages and play a greater role in the diagnosis and treatment of tubal infertility.
Application of "a trace" in the diagnosis and treatment of infertility
Cook's guide wire intervention in the United States is a cutting-edge technology for the treatment of tubal obstructive infertility. This technology can send the catheter guide wire to the tubal obstruction through vagina and uterine cavity through TV monitoring system, push it under direct vision, make the guide wire pass through the obstruction section, and inject the dredging fluid into the fallopian tube through the catheter. Clinical practice proves that the effective rate is over 98%.
Hysteroscopy, salpingoscopy combined with COOK guide wire technology can systematically treat various diseases of female reproductive system, thus achieving the effect of comprehensive treatment of infertility. It can comprehensively diagnose and treat reproductive system diseases in uterus, fallopian tube, umbrella tip, ovary and other parts, and a variety of diseases can also be treated by one combined operation to avoid the pain caused by multiple operations and create a good reproductive environment for women.