What is hysteroscopy god help!

Hysteroscopy Hysteroscopy: Hysteroscopy is a new, minimally invasive gynecological diagnostic and therapeutic technology that can be used to diagnose, treat, and follow up lesions in the uterine cavity. Hysteroscopy can not only determine the location, size, appearance and scope of the lesion, and can be on the surface of the lesion tissue structure for detailed observation, and under direct vision to take or positioning scraping, greatly improving the accuracy of the diagnosis of diseases in the uterine cavity, updating, development and make up for the shortcomings of the traditional diagnostic and therapeutic methods. For most of the patients who are suitable for diagnostic curettage, it is more reasonable and effective to perform hysteroscopic examination first to clarify the lesion site and then perform biopsy or curettage. Hysteroscopic surgery can diagnose and treat a variety of diseases, such as women's dysfunctional uterine bleeding, submucous fibroids, endometrial polyps, intrauterine devices and post-abortion embryonic tissue residues. After hysteroscopic treatment, not only can patients who need to remove the uterus by traditional methods avoid open surgery, but also can preserve the uterus, and hysteroscopic surgery is also safe for patients with bleeding disorders such as thrombocytopenia, hemophilia and leukemia. In addition, hysteroscopy can also be used to examine the vagina and uterine cavity of young girls and unmarried women, to accurately detect abnormalities there and treat them accordingly, and to protect the integrity of the hymen and alleviate the pain of patients. Hysteroscopy can also be used for the diagnosis of infertility, correction of uterine deformities, and if necessary, for the diagnosis of early endometrial cancer. The application of hysteroscopy in fallopian tube can be accessed through the "Chinese Tubal Specialty Network" for a more professional search. Definition: Hysteroscopy is an emerging minimally invasive gynecological diagnostic and treatment technology, which is essentially a fiber-optic endoscope, including the hysteroscope, energy system, light source system, irrigation system and imaging system. How to use hysteroscopy: Before the operation, the irrigation system is activated to expand the uterus, which ensures the pressure in the uterus and also plays the role of cooling and flushing. Hysteroscopes are categorized into examination hysteroscopes and surgical hysteroscopes. There are three different electrodes in the surgical hysteroscope, which are supported by an energy system, i.e., an electric current, for their proper functioning. In addition, for the accuracy of the surgery, there is a light source system and an imaging system to help. During the surgery, with clear lighting and monitoring by the imaging system, unclear vision is avoided and a guiding role can be played. The main use of hysteroscopy: hysteroscopy can not only determine the location, size, appearance and scope of the lesion, and can be on the surface of the lesion of the tissue structure for detailed observation, and under the direct vision of the material or positioning scraping, greatly improving the accuracy of the diagnosis of diseases in the uterine cavity, updating, development and make up for the shortcomings of the traditional diagnostic and therapeutic methods. For most of the patients who are suitable for diagnostic curettage, it is more reasonable and effective to perform hysteroscopic examination first to clarify the lesion site and then perform biopsy or curettage. Hysteroscopic surgery can diagnose and treat a variety of diseases, such as women's dysfunctional uterine bleeding, submucous fibroids, endometrial polyps, intrauterine devices and post-abortion embryonic tissue residues. After hysteroscopic treatment, not only can patients who need to remove the uterus by traditional methods avoid open surgery, but also can preserve the uterus, and hysteroscopic surgery is also safe for patients with bleeding disorders such as thrombocytopenia, hemophilia and leukemia. In addition, hysteroscopy can also be used to examine the vagina and uterine cavity of young girls and unmarried women, to accurately and promptly detect abnormalities there and treat them accordingly, and at the same time protect the integrity of the hymen and alleviate the pain of the patient. Hysteroscopy can also be used for the diagnosis of infertility, correction of uterine deformities, and, if necessary, for the diagnosis of early endometrial cancer. Indications for hysteroscopic treatment: 1. Regular uterine bleeding, including excessive menstruation, frequent menstruation, prolonged menstruation, irregular uterine bleeding, and so on. 2、Infertility and repeated spontaneous abortion: on the basis of comprehensive and systematic evaluation of both men and women, the cause of the disease in the uterine cavity will be explored and corrected. 3, Ultrasound, uterine tubal iodine oil imaging or diagnostic scraping examination suggests that there are intrauterine abnormalities or suspicious, can be confirmed, verified or excluded by hysteroscopy. 4. Those with intrauterine adhesion or intrauterine foreign body residue, the latter includes fetal bone fragments. 5、If endometrial cancer and its precancerous lesions are suspected, the application of hysteroscopy, localized biopsy combined with histopathological evaluation can help early diagnosis and timely treatment. 6、With appropriate patient selection and complete preoperative preparation, certain hysteroscopic surgery can replace or change the traditional treatment methods. 7, hysteroscopic diagnostic and treatment techniques in family planning clinical and scientific research: (1) intrauterine device IUD; (2) in the diagnosis and treatment of abortion and its complications; (3) hysteroscopic tubal sterilization research. 8, as follow-up and scientific research in the application of hysteroscopic treatment contraindications: 1, active uterine bleeding (small amount of bleeding or special indications of the exception) 2, acute or subacute reproductive tract infection 3, recent perforation of the uterus or uterine surgery history (within 3 months) 4, want to continue pregnancy. 5, Malignant tumors of the cervix. 6、Tuberculosis of the reproductive tract without appropriate anti-tuberculosis treatment. 7、Those with excessively narrow uterine cavity or cervix. 8、Serious heart, lung, liver, kidney and other organs diseases, metabolic acidosis and other intolerable people. 9, preoperative measurement of oral body temperature is not less than 37.5 degrees, suspend the examination or surgery. Complications of hysteroscopy: 1. Injury (1) Excessive pulling and dilatation of the cervix can lead to cervical injury or bleeding. (2) Uterine perforation: diagnostic hysteroscopy uterine perforation rate of about 4%, the American Association of Gynecologic Laparoscopists recently reported that the uterine perforation rate of surgical hysteroscopy is 13.0%. Severe uterine adhesions, scarred uterus, excessive anterior or posterior flexion of the uterus, postoperative cervical surgery, atrophied uterus, and lactating uterus are all susceptible to uterine perforation. Sometimes the perforation goes undetected and the surgical operation is continued, which may lead to severe bowel injury. Perforation mostly occurs at the bottom of the uterus. Simultaneous monitoring with laparoscopy may reduce the incidence of perforation. Once perforation occurs, operation should be stopped, instruments withdrawn, estimation of the perforation should be made, and abdominal pain and vaginal bleeding should be carefully observed. 5 mm perforation of the examining scope has no obvious sequelae, whereas perforation during hysteroscopic surgery needs to be considered for open laparotomy or laparoscopy. Special care should be taken for perforations due to electrocoagulators and lasers used in recent years. During hysteroscopic electrosurgery, the bowel attached to the surface of the uterus may be injured by heat conduction, or the electrocoagulator may perforate into the abdominal cavity and cauterize the bowel, ureter, and bladder. Simultaneous monitoring with laparoscopy during hysteroscopic electrodesiccation can assist in draining the bowel, confirming that the bladder is empty, and minimizing complications. Hysteroscopic tubal cannulation may damage the uterine horns, and carbon dioxide gas expansion can lead to rupture of the tubal fluid and gas entry into the broad ligament to form an emphysema. 2. Bleeding After hysteroscopy, there is usually a small amount of vaginal bleeding, mostly within a week. Hysteroscopic surgery can be due to cutting too deep, poor contraction or intraoperative hemostasis is not complete bleeding, can be used to stop bleeding with electrocoagulators, can also be used to stop bleeding with Foley catheter compression for 6 to 8 hours. 3. Infection The incidence of infection is low. The occurrence of infection can be avoided by mastering the indications and contraindications, applying antibiotics appropriately before and after surgery, and strictly sterilizing the instruments. 4. Complications caused by expansion of the uterus The over-absorption of expansion fluid is a common complication of expansion of the uterus, mostly occurring in the hysteroscopic surgery, and the expansion of the uterus pressure is too high, the endometrial damage area is large. Expansion of the uterus when the pressure is maintained at 100mmHg (13.3kPa) can be, too high pressure is not conducive to a clear field of vision, but to promote the liquid through the vein or tubal flow of the abdominal cavity is absorbed in large quantities. The operation time is too long, also easy to lead to excessive absorption, resulting in excessive blood volume and hyponatremia, causing a series of systemic symptoms, and in severe cases, can lead to death. The use of carbon dioxide as the inflation medium, if the inflation rate is too fast, may lead to serious complications or even death. At present, a special inflation device is used, and the inflation speed is controlled at 100ml/min, which avoids the occurrence of complications. Postoperative shoulder pain caused by carbon dioxide inflation is due to carbon dioxide stimulation of the diaphragm. Complications of hysteroscopy are very dangerous: in developed countries, intravenous anesthesia or general anesthesia intubation is used for analgesia during hysteroscopy, but in China, due to the limitation of conditions, anti-inflammatory pain suppositories, anesthesia of the paracervical nerve block, and surface anesthesia of the cervical canal mucous membrane are usually used for analgesia, but most of the people still feel that the pain is hard to tolerate, and a few of them also have the manifestations of vomiting, cold sweat, shock, and other similar abortion syndromes. Despite the rapid development of hysteroscopic technology, however, once complications occur, the consequences are very dangerous, such as hyponatremic encephalopathy. Overseas has reported a healthy young woman, with hysteroscopy to remove small fibroids, due to hyponatremia led to permanent brain damage, as a result, the surgeon and the hospital was awarded compensation of more than 20 million U.S. dollars. China has a hospital, excited to purchase equipment, did not expect the first case of hysteroscopic surgery on the uterine perforation, the result of the hospital compensation, the doctor "go", hundreds of thousands of dollars of equipment has been idle. The vast majority of complications of hysteroscopic technology is caused by improper operation, theoretically speaking, should be able to avoid. Regrettably, some doctors are not good enough to rush into the field and inevitably have to go wrong. Ms. Z, because of uterine bleeding, hysteroscopy, do not want to check the occurrence of venous air embolism, due to the doctor is not familiar with the treatment of this unexpected serious complications, and ultimately lost the opportunity to rescue, Ms. Z died after the tragedy of Ms. Z, the surgeon deliberately called Beijing from abroad "for help". After Ms. Z's tragedy, the surgeon deliberately called Beijing from overseas to "ask for help". Upon learning that this doctor didn't even know that the patient died of air embolism and why this complication occurred, the professor in Beijing was a bit teary-eyed....... Complications of hysteroscopic surgery are relatively rare, but the consequences are quite serious. Things like uterine perforation, due to the electrified operation, can often cause fatal damage to adjacent organs. And complications like fluid overload, hyponatremia, and venous air embolism simply don't happen in conventional surgery. In other words, the mechanism of some complications is directly related to the performance of high-tech instruments. As hysteroscopic technology is new, the initial stage of complications are unlikely to occur, the key lies in the doctor to systematic learning, to be able to early detection, the correct treatment. The reporter learned that in order to make this new technology normal development, with hysteroscopy must be abdominal surgery experience of attending physicians and above, and to undergo formal training, master the diagnosis of various complications and first aid treatment methods, to be repeatedly practiced away from the body to operate until the brain, eyes, hands, feet with the coordination of the ...... hysteroscopy diagnosis and treatment technology officially! The hysteroscopic diagnosis and treatment technology has been officially "settled" in China's obstetrics and gynecology clinic for more than ten years. Because this new technology set of electricity, light, ultrasound, imaging, video technology and medical care as a whole, less trauma, good efficacy, but the operation is difficult and risky, so some experts compare it to the "Boeing 747" --- driving! Good to be able to fly straight up to the sky, and vice versa, "the plane will be destroyed". Advantages of hysteroscopy Edit paragraph Precise determination: high-tech minimally invasive diagnostic and therapeutic instruments to maximize the precise determination of intrauterine lesions; Diagnosis is more accurate: high-tech fiber-optic endoscopy, including hysteroscopy, energy system, light source system, perfusion system and imaging system, more direct, accurate, reliable, reduce leakage of diagnosis, and significantly improve the diagnostic accuracy, not only to directly see the examination of the uterus physiological, pathological lesions, but also to unblock the blocked fallopian tubes. Can unblock the occluded fallopian tubes, remove submucosal fibroids, or remove the endometrium that causes bleeding; Surgery without laparotomy: a model of minimally invasive surgery, hysteroscopic surgery is characterized by less pain, less bleeding, shorter operation time, quicker postoperative recovery, shorter hospitalization time, fewer complications, and does not affect the function of the ovaries, etc., and it preserves the physiological integrity of the uterus and is less traumatic. Indications for hysteroscopy edit this paragraph 1, frequent uterine bleeding: including excessive menstruation, frequent menstruation, prolonged menstruation, irregular uterine bleeding, etc.; 2, infertility and recurrent spontaneous abortions: on the basis of a comprehensive and systematic assessment of the men and women, to explore the cause of the pathology of the uterine cavity and to be corrected; 3, on the tubes and other pathology of the final confirmation of the diagnosis: ultrasound, uterine tubal iodine-oil angiography or diagnostic scraping examination suggests that there are abnormalities or suspected, can be confirmed by the hysteroscopy. It can be confirmed, verified or excluded by hysteroscopy; 4. Determination of abnormal conditions in the uterine cavity: for those who have adhesions in the uterine cavity or foreign body residues in the uterine cavity, the latter includes fetal bone fragments, etc.; 5. Detection and treatment of endometrial cancer and lesions: for those who are suspected to have endometrial cancer and its pre-cancerous lesions, hysteroscopy should be applied to carry out examination, and the localization of biopsy combined with the evaluation of histopathology will help in the early diagnosis and timely treatment; 6, Clinical application of family planning: (1) intrauterine device IUD; (2) application in the diagnosis and treatment of abortion and its complications; (3) hysteroscopic tubal sterilization diagnosis and treatment.