The Use of 3mm Optical System at Hysteroscopy

Overview

Objective:
To evaluate our first experience with 3mm hysteroscope.Design: Prospective study.Setting: Department of Obstetrics and Gynecology, 1st medical Faculty, Charles University, Prague.Methods: 105 hysteroscopic procedures in normal saline as distension fluid were performed betweenJune and November 2001. We performed 60 (57.1%) diagnostic procedures and 45 (42.9%)minor surgical intrauterine interventions (mainly endometrial polyp < 2 cm ressection).We used Versascope (Gynecare, Johnson & Johnson) 1.9 mm optics with 3.2 mm expandableoperative sheath. All diagnostic procedures were done by minimal invasive way – using vaginoscopicapproach. Main part of procedures were performed without any anaesthesia. In case ofoperative intervention we used Versapoint bipolar electrodes in normal saline and active outflow.Results: The surgeon evaluated the intrauterine findings and the patient evaluated subjectivecomfort during the procedure (comfortable, uncomfortable, painful). No complications were registeredduring or post procedure. 83 (73%) women undergone diagnostic procedure described theprocedure without discomfort, 22 (21%) women described a moderate discomfort with pressure inthe lower abdomen (all undergone intrauterine surgical intervention). No patient described severediscomfort or wish to have general anesthesia.Conclusion: Miniaturized optical systems allows us to perform most cases of diagnostic and surgicalintrauterine interventions (after proper patient selection) in an outpatient or office setting.

Key words:
hysteroscopy, vaporisation, transcervical surgery