Video-endoscopic procedures that are part of the evaluation minimally invasive of the woman within Hysteroscopy is the most important, and with the greatest potential in Gynecologic evaluation clinic. In fact, Hysteroscopy is the ideal procedure for structural and functional evaluation of the uterine cavity in the office and without any previous preparation, local anesthesia or vaginal invasion with traditional instruments.

It is so versatile that diagnosed and allows to treat immediate injuries that would otherwise require, aggressively inefficient and unnecessary words, the use of an operating room, anesthesia, surgical environments complex and cumbersome procedures administrative, in the majority of cases.

Hysteroscopy evaluates directly and efficiently the uterine cavity and its contents through the use of cameras in miniature with a diameter less than 3 mm and equipment, enabling the entry of miniature surgical instruments to make surgical procedures direct on found lesions.

By do a curettage under anesthesia, inefficient, expensive and painful if you can do a Hysteroscopy that diagnoses and eliminates the problem without damaging healthy tissue, virtually painless way and with a minimal cost and recoverable if this insured?

Do by the risk of undergoing a biopsy to blind, painful and annoying that does not guarantee that the lesion was biopsied? Even the uterine curettage does not guarantee the total removal of the lesion, not even that the lesion to be extracted.

Old Gynecology resists new methods because it requires training and radical changes in the way of thinking, I resisted me…

I resisted because I thought my efficiency diagnosed was very high and maybe that it has been on many occasions, but doubt is to review the overwhelming evidence that exposes the current literature. Evidence indisputably determined that Hysteroscopy is the study by excellence of the endometrial cavity.

I resisted because I thought that it was cumbersome, complex and costly and however already had clear that intellectual honesty required reference for my patients to other specialists who practised hysteroscopies to offer them the best option available for your problem: rarely endometrial biopsies and much less curettage or gynecological uterine curettage blind because I was sure that would result in some form of professional dishonesty as doctor (obstetric curettage remains in force, in cases of abortion incomplete).

And I started to do them after training with one of the best and most recognized histeroscopistas local (and the world), who incidentally was referring all of my patients and who finally convinced me to integrate their training group.

This introduction explains informally part of the professional process that leads to changes in mentality and adaptation personal that should be to apply what better understanding physician of the time suggested. This takes years and sometimes never occurs.

Do you mean this? If the gynecologist does not have or does not know the presence and importance of modern methods becomes a little perfect professional and that potentially incurred malpractice medical by default.

The procedure in the office

At least 75% of the cases that require evaluation, diagnosis, and surgical resolution can be resolved in the practice of immediately and without obvious discomfort

The hysteroscope, instruments and the procedure in the office

The hysteroscope is a tool integrated into a small video camera (video endoscopy) that allows its introduction into the uterus to visualize with great increase, on one or several monitors, the contents of the uterine cavity (endometrial cavity), the cervix and vagina. This instrumental is so fine that it you can enter inside the uterus virtually painless way, in a matter of seconds and without any prior preparation, without analgesia, anesthesia, antisepsis and vital surveillance. Which means that it can be in a basically normal office. In colloquial terms is a tube with a camera that allows you to see inside the uterus, and can be photographing or filming the entire procedure. This procedure is called VAGINOHISTEROSCOPIA because the instrument is inserted through the vagina until you reach the uterus without speculums or cervical tenaculum (comfort)

Teams are very sophisticated and expensive but the investment is worthwhile since offers the patient the means of evaluation according to the reality medical and your best interests.

The hysteroscope allows the introduction of surgical instruments in miniature that solves at least 50-75% of the problems that led to the study of the patient.

Indications

Polyps are benign tumors of glandular origin arising as small soft balls that bleed to the contact and that alter the menstrual pattern of the patient. Find more frequent, they are occasionally associated with pre-malignant and malignant lesions. They are also associated with infertility. They must always be extracted

Bleeding postmenopausal, directed, endometrial biopsy suspicious changes of the endometrial surface should be studied through guided biopsy of evident injuries. The ideal study for the genital bleeding in postmenopausal women is Hysteroscopy has been shown to have little sensitivity to blind and curettage biopsy diagnosed

Removal of IUD or foreign bodies, sometimes the IUD is "lost" in the uterine cavity and their threads are not accessible for removal blindly with tongs or traditional instruments. In these cases histeroscopicas tweezers solve the problem efficiently and to allow the rest of the endometrial cavity sequential review to rule out diseases incidental

Evaluation of the infertile woman, in cases where there is no evidence of detectable pathologies shown Hysteroscopy which may suggest conditions subtle as asymptomatic chronic endometritis, adenomyosis (a form of endometriosis) and phenomena of inflammation Vascular autoimmune (vasculitis) that could affect the correct implantation of an embryo. Of course, if there are structural as polyps and fibroids finds is they could solve in the office or in the operating room as the case may be

Surgical sterilization minimally invasive, through the use and introduction of specially designed devices are may occlude irreversibly fallopian tubes since its origin in utero definitely sterilize women without need to intervene by laparoscopy or open surgery. All of this without use of an operating room and anesthesia. The device is commercially called Essure

Myomectomy, in the office and without anesthesia or energized equipment can remove fibroids pediculated completely intracavitary less than 10 mm

Hysteroscopy under anesthesia is reserved for those cases in which Office Hysteroscopy cannot resolve the problem and those that will require surgical energy. Always a diagnostic Hysteroscopy is performed prior to the patient to the operating room.