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Gynaecological endoscopy

Published: 16 March 2017|Last updated: 30 November 2020|

Gynaecological endoscopy is a surgical discipline which uses optical instruments specially designed to help diagnose the most frequent female disorders and pathologies such as some infertility problems, small vaginal hemorrhages or endometrial polyps among others. Gynaecological endoscopy employs hysteroscopy and laparoscopy for these purposes.

Endoscopy is the direct observation of an organ or cavity by means of an endoscope inserted through natural orifices or small incisions. In this way, we obtain more accurate and reliable information than using other external exploratory techniques.

Gynaecological endoscopy as we know it is nowadays is possible thanks to important technical advances, along with the sophistication and the miniaturization of the equipment used. Modern anaesthetic medicine has also played an important part in the development of surgical procedures. This medicine is extremely effective, wears off quickly and its side effects have been reduced so that it can be used effectively in ambulatory surgery. Among other advances this made possible the so called minimally invasive surgery which owes its name to the fact that very small incisions are made and the intervention is ambulatory.

Gynaecological endoscopic surgery is a modern discipline which unites advances in both gynaecological endoscopy and minimally invasive surgery and which allows for surgical interventions without the need for a major operation. The recovery is prompt and the patients can return to their routine activities immediately. Local, regional anaesthesia or sedation (general superficial anaesthesia of a short duration) are used. For security reasons, the procedure takes place in a fully-equipped operating theatre.

Ambulatory gynaecological surgery uses modern optical instruments such as a hysteroscope, which is introduced via the neck of the uterus, or a laparoscope inserted via a minute incision in the navel.

Hysteroscopy
Diagnostic hysteroscopy is an incision-free procedure that helps visualise the interior of the uterine cavity or uterus. In order to do this, a hysteroscope, (a kind of miniscule telescope of only 4 millimetres in diametre) is inserted via the neck of the uterus.

It is not necessary to make an incision as a natural orifice, the neck of the uterus, is used. Normally it is carried out without anaesthetic; Occasionally local anaesthetic is used. This ambulatory procedure lasts between 20 and 30 minutes.

Operative hysteroscopy
When an endometrial polyp has to be removed, the operative hysteroscopy allows for its extraction by means of a technically simple intervention which is often carried out under local or regional anaesthetic.

This procedure requires the use of a surgical hysteroscope which allows for the introduction of the instruments necessary to carry out the intervention and resolve this and other endometrial or uterine problems (myomas).

Laparoscopy is a minimally invasive surgical technique which allows access to the abdominal cavity through a small incision without the belly without the need for a major operation.

This procedure is carried out under anaesthetic sedation, the recovery is fast and the patient can leave the clinic in 2 or 3 hours. It allows for the visualisation of the interior genital organs such as the uterus, the ovaries and the Fallopian tubes so that a diagnosis can be made when the patient has chronic pelvic pains, in cases of infertility, etc.

The recovery from endoscopic gynaecological surgery is faster than in classic surgery cases as interventions are short and the patients stay in the medical centre for a very short period of time. Post-operatorial infections are less probable than with conventional surgery.

At the same time, the costs of the procedure are reduced when it is carried out in a smaller surgical unit in comparison to larger hospitals and clinics.

It is worth mentioning that these modern surgical techniques are meticulous, while anaesthetic procedures allow for a fast recovery. Side-effects are almost non-existent.

By means of endoscopic surgery it is possible to find out without surgical intervention the origin of vaginal haemorrhages or anatomical alterations. We can discern between:

  • Endometrial alterations (atrophies or hyperplasia)
  • Endometrial polyps
  • Endometrial adhesion
  • Uterine septa or malformations
  • Myomas (benign tumors)

Gynaecological endoscopic surgery prevents the need for a major operation in cases of endometriosis and ovarian tumors. It is the fastest way of carrying out tubal ligation and is effective for diagnosing certain cases of infertility.

The article highlights the need for technological advances in order to evolve in the field of medicine and scientific research. In this case, the invention of tiny devices that enable one to operate inside the body without the need for open surgery has greatly improved the conditions of patients.

The use of gynaecological endoscopy for diagnostic purposes by specialists with experience in its monitoring ensures optimum efficiency and reliability in the interpretation of imaging while minimising the risk of possible complications.

As for its use for surgical purposes, it has facilitated the treatment of gynaecological pathologies in a much less aggressive way. This technique allows a patient to be operated on without having to substantially modify her professional or social activity, while still maintaining its effectiveness.

In conclusion, gynaecological endoscopy is one of the latest, most effective and minimally invasive surgical procedures used both for diagnostic purposes and for the treatment of gynaecological disorders.

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