ENDOSCOPY IN GYNAECOLOGY

Objectives

At the end of this session you should be able to ….

1. Enumerate the advantages of laparascopy over laparatomy

2. List indications and complications of laparascopy and hysteroscopy.

Advantages of laparascopy

Indications of laparascopy

Diagnostic:

•Infertility•Endometriosis•Acute/chronic pelvic pain•Evalaution of adnexal mass

Operative :

•Sterilisation•Ectopic •Ovaraian cysts•Tubal recanalisation•Myomectomy•Hysterectomy

Complications :

Subcutaneous emphysema Injury to vessels like aorta, vena

cava,inferior epigastric artery, common iliac artery.

Injury to bowel and bladder, ureter. Anesthesia complications.

Basic equipments

VERESS NEEDLE

Trocar

laparascope

Camera

Instruments

Entry points

Trocar placement

Indications of hysteroscopyDiagnostic

•Intrauterine lesions like

polyp, submucous myoma

•Missing IUCD

•Intrauterine adhesions for

secondary amenorrhoea

• Uterine anomalies

• Postmenopausal bleeding

Operative

• Tubal cannulation

•Septal resection

• Myomectomy

• Sterilisation

•Removal of IUCD

•Polypectomy

•Adhesiolysis

Complications of hysteroscopy

Hemorrhage Uterine perforation Electrolyte disturbances Infection