Hysteroscopy Surgery

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INTRODUCTION AND OVERVIEW

Hysteroscopy surgery is a safe, simple, minimally invasive, and daycare procedure. Hysteroscopy does not require any cuts and is a scarless procedure. It requires the use of slender and delicate instruments or hysteroscopy instruments alongside the hysteroscope. Hysteroscopy is a technological miracle and a boon for diagnosis and treatment of many female concerns. Hysteroscopy is often used by your gynecologist to examine the inside of the uterus in order to diagnose and treat some conditions of the uterus.

Operative hysteroscopy is used to treat various conditions causing either infertility or bleeding problems in a woman. Operative hysteroscopy allows the surgeon to remove fibroid, adhesions, or septum or do metroplasty which is the correction of the abnormal shape of the uterus. These are.

Expert gynecologist Dr. Dimple Doshi at Vardaan hospital, Goregaon West, Mumbai has done thousands of successful hysteroscopies resulting in accurate diagnosis, treatment, and a great relief to the patients suffering from long-standing undiagnosed problems.

What is Hysteroscopy surgery?

Hysteroscope is a thin lighted tube that is connected to a high-definition camera that is attached to a high-definition monitor that displays the images of the inside of the uterus. The hysteroscope is always covered inside the hysteroscopy sheath which allows the entry of other hysteroscopy instruments.

ICD-10 Codes for Hysteroscopy

N85.0– Er dometrial hyperplasia

N85.8-Other specified noninflammatory disorders of the uterus

N92.0-Excessive and frequent menstruation with regular cycle

N93.8– Other specified abnormal uterine and vaginal bleeding

D25.1-Intramural leiomyoma of uterus (for fibroids)

C54.1– Malignant neoplasm of endometrium

CPT Codes for Hysteroscopy

58555– Hysteroscopy, diagnostic (separate procedure)

58558– Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D&C

58559– Hysteroscopy, surgical; with lysis of intrauterine adhesions (Asherman’s syndrome)

58561– Hysteroscopy, surgical; with removal of leiomyomata (fibroids)

58563– Hysteroscopy, surgical; with endometrial ablation (for abnormal uterine bleeding)

58565– Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion (for sterilization)

Benefits Of Hysteroscopy

Hysteroscopy is a stitchless procedure; No cuts on the abdomen or anywhere else
Day care or an outpatient department procedure
There is no or very minimal pain with hysteroscopy
Many conditions of the uterus can be diagnosed accurately by doing hysteroscopy.
Certain pathologies like fibroids or polyps can be removed directly by hysteroscopy.
Hysteroscopy may be combined with laparoscopy for cases of infertility.
Hysteroscopy may be combined with D and C for accurate diagnosis.
Fast recovery
Short hospital stay
Avoidance of hysterectomy in certain conditions
Less pain

Why Is Hysteroscopy Done? What Are The Indications Of Hysteroscopy?

Hysteroscopy is used for diagnostic purposes like:

To assess the size and shape of the uterine cavity whenever you are finding it difficult to get pregnant.
To see the inside of the uterus in case of abnormal uterine bleeding or postmenopausal bleeding.
To diagnose septum
To diagnose a condition called isthmocele
Second look hysteroscopy after either septum resection, anti-tubercular treatment, or myoma resection.

Hysteroscopy is also used for surgical procedures like:

Metroplasty or the correction of the shape of an abnormal uterus.
To remove the septum ; also called septum resection or septoplasty
To remove the submucosal fibroid.
To remove the adhesions inside the uterus developed due to infection, surgery or D and C
To open up the block of the fallopian tube(s).
To take the site specific biopsy in a case of abnormal uterine bleeding or post menopausal bleeding
To correct ishmocele .
To remove cesarean scar ectopic pregnancy
To diagnose the cause of repeated miscarriages.
To remove the lost copper T or intrauterine device.

Preparations For Hysteroscopy

You will be asked to do the routine blood investigations; to see your primary fitness.
Your doctor may ask you to do an ultrasonography
X ray chest and ECG may be required for a complicated hysteroscopic surgery like adhesions removal or the removal of a big fibroid.
You will be asked to continue your thyroid, blood pressure or diabiees medicines and will be asked to stop medicines like aspirin, contraceptive pills or any oral anticoagulants.

How Is Hysteroscopy Procedure Performed

Anesthesia: Hysteroscopy is done under short general anesthesia or sedation
Duration : 8 to 10 min for diagnostic procedure and 15 to 40 min for operative hysteroscopy procedure.
Hospitalisation : It’s a day care procedure. But if hysteroscopy is done with laparoscopy or if a complicated hysteroscopy surgery is done, you may be asked to stay for one night in the hospital .
After you are put to sleep,your gynecologist will gradually dilate your uterine cavity with normal saline using a device called hysteromat. The constant saline instillation distends the uterine cavity and threby allows your surgeon to see inside the cavity. A systematic examination will be done ; your surgeon will try to locate the openings of the fallopian tubes and make sure that they are patent. A panoramic view of the entire cavity is obtained and presence of any fibroids, adhesions or septum is noted.If required, your surgeon will introduce hysteroscopy instruments through the hysteroscopy sheath and perform the required procedure. Once complete, your surgeon withdraws the hysteroscope and proceeds with D and C which is usually combined with it.

How Is The Hysteroscopy Recovery

Stay: Hysteroscopy is a daycare procedure and you will be allowed to go home on the same day after 2 to 3 hrs observation.

diet : You will be allowed to have full diet after 2 to 4hrs.

Mobilisation: You will be allowed to walk after the effect of sedation wears off; about 15 min to 1 hr after hysteroscopy is over.

Pain: Is hysteroscopy painful? Hysteroscopy is associated with little or no pain and the post-procedure period is comfortable.

Bath: After hysteroscopy, you will be allowed to take bath the same day.

Follow up: you will be called for follow-up after 5 to 6 days.

COMPLICATIONS OF HYSTEROSCOPY:

Anesthesia-related complications

Procedure-related complications:

Excessive bleeding
Fluid overload
Perforation
Infection

You will be asked to report immediately if you develop any of these symptoms like fever, excessive bleeding, urinary or bowel problems, or severe abdominal pain.

FAQ On Hysteroscopy

Q: What Is Hysteroscopy?
A: Hysteroscopy is a procedure in which a slender hysteroscope is inserted through the cervix to view the inside of the uterus.

Q: Why Would You Need A Hysteroscopy?
A: Hysteroscopy is done to assess the uterine cavity in cases of infertility; whenever there are bleeding problems like post-menopausal bleeding or heavy menstrual bleeding due to thick endometrial lining.

Q: Is Hysteroscopy Painful?
A: Office hysteroscopy involves using a very thin; 2mm hysteroscope to view the inside and this is not painful. While for the standard hysteroscopy; minimal sedation is given so you sleep off during the procedure and do not feel the pain.

Q: Is Hysteroscopy A Major Surgery?
A: Hysteroscopy is considered minor surgery and does not require an overnight stay.

Q: How Is Hysteroscopy Performed?
A: The uterus is inflated with normal saline to view the inside of the cavity. Once inflated there will be space in an otherwise collapsed cavity and that lets your doctor see; assess and diagnose problems like adhesions; fibroids or septum.

Q: Will Hysteroscopy Delay The Periods?
A: Diagnostic hysteroscopy does not delay the periods except when procedures like myomectomy or endometrial ablation are done.,

Q: Will Hysteroscopy Affect Ovulation?
A: No, it does not affect ovulation.

Q: What Is Diagnostic Hysteroscopy?
A: As the name suggests; diagnostic hysteroscopy is used to diagnose conditions like fibroids; septum or adhesions inside the uterus or to assess the uterine cavity in cases of infertility.

Q: What Is The Cost Of Hysteroscopy In Mumbai?
A: Hysteroscopy cost in Mumbai ranges from 20000 to 60000.