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.
There are three types of endoscopic surgery in obstetrics and gynaecology: laparoscopy; hysteroscopy; and salpingoscopy. Laparoscopy – With the advances in technology, laparoscopic surgery is rapidly and progressively replacing conventional surgery except for the most difficult cases. Diagnostic laparoscopy is an invaluable tool for assessing patients with chronic pelvic pain, infertility, adhesions and endometriosis, and an adjunct in grading of gynaecological cancers. The excellent visualization of the peritoneal cavity not only aids in diagnosis, but also allows for an accurate assessment of the severity of these conditions. The laparoscopic approach is now the preferred method for the treatment of myoma uteri, ovarian tumours, ectopic pregnancy, infertility, endometriosis and inflammatory masses.
Hysteroscopy – Hysteroscopy has proven to be invaluable in assessing patients with abnormal uterine bleeding, postmenopausal bleeding, infertility and recurrent pregnancy loss. During hysteroscopy the uterine cavity is dilated with liquid and then a resectoscope or hysterofiberscope is used. The development of hysteroscopes with operating channels and instruments such as scissors, biopsy forceps, snares and electrosurgical operating devices such as ball and loop electrodes allow many operative procedures to be performed hysteroscopically. The main indications for hysteroscopic surgery are submucous myoma uteri, uterine anomalies, and Asherman syndrome. Female sterilization can also be performed hysteroscopically with the use of various mechanical occlusive devices or plugs (e.g. Essure).
