the hysteroscope is used just to observe the inside of the uterus During
operative hysteroscopy, the resectoscope, a type of hysteroscope, is used,
which has revolutionized surgery inside the uterus. The resectoscope has
channels through which it is possible to insert very thin surgical instruments.
It also has a wire loop that uses high-frequency electrical current to cut or
coagulate tissue. These instruments can be used to remove polyps and fibroids,
to cut adhesions, and do other intra uterine procedures. Procedures using the
resectoscope are done in an operating room setting, under general anaesthesia,
but as an outpatient procedure. There are no stitches with this procedure.
Abnormal uterine bleeding may be due to a hormone imbalance or the presence of
abnormal tissues such as fibroids (myomas), polyps, or cancer of the
endometrium or uterus. If a specific cause for abnormal bleeding is identified,
treatment is directed to that cause. If no specific anatomical cause is
identified or if hormone disturbances do not improve with hormonal therapy,
endometrial ablation (destruction of the uterine lining) may be an alternative
Listed below are operative procedures that can be carried out through the
Endometrial ablation is a procedure to permanently remove a thin tissue layer
of the lining of the uterus (the endometrium) to stop or reduce excessive or
abnormal bleeding in women for whom childbearing is complete. The lining is
destroyed with a mild electrical current or heat. This process prevents the
lining from growing back. A woman cannot become pregnant after ablation though
she still has her reproductive organs.
It is offered to those patients who do not want their organs removed and for
patients who do not want or are not fit for major surgery.
An ablation is not recommended if :
The patient desires to keep her fertility.
The uterine cavity is very large (greater then 12 cms)
Severe dysmenorrhea (menstrual cramps)
Most women are able to go home within an hour after the endometrial ablation.
There may be mild cramping, which can usually be relieved by pain killers.
After an ablation the bleeding decreases. For some women it may stop
altogether. The first few periods may be heavy after the procedure but
thereafter it settles down Even if the bleeding does not stop completely, the
flow is likely to be much lighter.
This procedure is done to increase the size of the uterine cavity when the
uterus has not developed sufficiently in size (hypoplastic uterus) due to
congenital problems (problems from birth).
The procedure is done using the resectoscope, in patients with a T shaped uterus
or a small uterine cavity. Vertical slits are made in the sides of the uterine
wall to enlarge the uterine cavity. Pregnancy implantation rates are known to
improve following this procedure.