Operative hysteroscopy is a minimally invasive procedure used to diagnose and treat various structural abnormalities within the uterus. As a gynecological surgeon, I utilize this advanced technique to address conditions that may affect a woman’s reproductive health and overall well-being. This approach allows for direct visualization and treatment of uterine issues through the natural opening of the cervix, eliminating the need for abdominal incisions.

The path to operative hysteroscopy begins with a thorough evaluation of the patient’s symptoms and medical history. Diagnostic imaging, such as ultrasound or hysterosalpingogram, often precedes the procedure to identify potential abnormalities. Once the need for operative hysteroscopy is established, we work together to prepare for the procedure and discuss what to expect.

Operative hysteroscopy can address several uterine structural abnormalities, including:

1. Polyp Removal: Uterine polyps are overgrowths of the endometrial lining that can cause abnormal bleeding and fertility issues. During hysteroscopy, these polyps can be visualized and removed using specialized instruments.
2. Uterine Septum Resection: A uterine septum is a congenital malformation where a wall of tissue divides the uterine cavity. This condition may increase the risk of miscarriage or preterm delivery. Hysteroscopic resection of the septum can normalize the uterine cavity shape.
3. Adhesion (Scar Tissue) Treatment: Intrauterine adhesions, also known as Asherman’s syndrome, can form due to previous surgeries or infections. These adhesions can cause menstrual abnormalities and fertility problems. Hysteroscopy allows for the careful removal of these adhesions, potentially restoring normal uterine function.

The operative hysteroscopy procedure typically involves the following steps:

1. Cervical Dilation: The cervix is gently dilated to allow passage of the hysteroscope.
2. Hysteroscope Insertion: A thin, lighted instrument with a camera is inserted through the cervix into the uterus.
3. Uterine Cavity Distention: The uterus is filled with fluid or gas to expand it, allowing better visualization of the cavity.
4. Examination and Treatment: The surgeon examines the uterine cavity and performs the necessary treatment using specialized instruments passed through the hysteroscope.
5. Completion: Once the procedure is finished, the instruments are removed, and the patient is taken to recovery.

Operative hysteroscopy offers several benefits. It’s typically performed as an outpatient procedure, allowing patients to return home the same day. Recovery time is generally shorter compared to traditional open surgery, with many women able to resume normal activities within a few days.

However, it’s important to understand that every patient’s experience is unique. Some may experience mild cramping or light bleeding following the procedure. Rarely, more serious complications such as uterine perforation or infection can occur. These risks are thoroughly discussed during the informed consent process.

As the surgeon, my role is to ensure the procedure is performed safely and effectively. This involves careful planning, precise execution of the operative technique, and close monitoring during and after the procedure. Postoperative care instructions are provided to support optimal healing and recovery.

The outcomes of operative hysteroscopy can be quite positive. Many women experience relief from symptoms such as abnormal bleeding or pelvic pain. For those seeking to conceive, treating these structural abnormalities may improve fertility outcomes. However, it’s important to have realistic expectations, as results can vary depending on the specific condition and individual factors.

Operative hysteroscopy represents a significant advancement in gynecological care, offering a minimally invasive approach to treating uterine structural abnormalities. As medical technology continues to evolve, we can expect further refinements in techniques and instruments, potentially expanding the applications of this valuable procedure.