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.

Gynaecological endoscopy as we know it is nowadays possible thanks to important technical advances, along with the sophistication and the miniaturization of the equipment used. Modern anaesthetic medicine has also been important for the development of surgical procedures. This medicine is extremely effective, wears off quickly and its side effects have been reduced so that it can be used effectively in ambulatory surgery. Among other advances this made possible the so called minimally invasive surgery which owes its name to the fact that very small incisions are made and the intervention is ambulatory.

Ambulatory gynaecological surgery

Gynaecological endoscopic surgery is a modern discipline which unites advances in both gynaecological endoscopy and minimally invasive surgery and which allows for surgical interventions without the need for a major operation. The recovery is prompt and the patients can return to their routine activities immediately. Local, regional anaesthesia or sedation (general superficial anaesthesia of short duration) are used. For security reasons, the procedure takes place in a fully-equipped operating theatre.

Ambulatory gynaecological surgery uses modern optical instruments such as a hysteroscope, which is introduced via the neck of the uterus, or a laparoscope inserted via a minute incision in the navel.

Hysteroscopy

Diagnostic hysteroscopy
Diagnostic hysteroscopy is an incision-free procedure which helps visualise the interior of the uterine cavity or uterus. In order to do this, a hysteroscope, (a kind of miniscule telescope of only 4 millimetres in diametre) is inserted via the neck of the uterus.

It is not necessary to make an incision as a natural orifice, the neck of the uterus, is used. Normally the intervention is carried out without anaesthetic; Occasionally local anaesthetic is used. This ambulatory procedure lasts between 20 and 30 minutes.

Operative hysteroscopy
When an endometrial polyp has to be removed, the operative hysteroscopy allows for its extraction by means of a technically simple intervention which is often carried out under local or regional anaesthetic.
This procedure requires the use of a surgical hysteroscope which allows for the introduction of the instruments necessary to carry out the intervention and resolve this and other endometrial or uterine problems (myomas).

Laparoscopy
Laparoscopy is a minimally invasive surgical technique which allows intervention in the abdominal cavity without the need for a major operation.

This procedure is carried out under anaesthetic sedation, the recovery is fast and the patient can leave the clinic in 2 or 3 hours. It allows for the visualisation of the interior genital organs such as the uterus, the ovaries and the Fallopian tubes so that a diagnosis can be made when the patient has chronic pelvic pains, in cases of infertility, etc.

Advantages of endoscopic gynaecological surgery
The recovery from endoscopic gynaecological surgery is faster than in classic surgery cases as interventions are short and the patients stay in the medical centre for a very short period of time. Postoperatorial infections are less probable than with conventional surgery.

At the same time, the costs of the procedure are reduced when it is carried out in a smaller surgical unit in comparison to larger hospitals and clinics.

It is worth mentioning that these modern surgical techniques are meticulous, while anaesthetic procedures allow for a fast recovery. Side-effects are almost non-existent.

Gynaecological endoscopic surgery uses

By means of endoscopic surgery it is possible to find out without surgical intervention the origin of vaginal haemorrhages or anatomical alterations. We can discern between:
– Endometrial alterations (atrophies or hyperplasia)
– Endometrial polyps
– Endometrial adhesion
– Uterine septa or malformations
– Myomas (benign tumors)

Gynaecological endoscopic surgery prevents the need for a major operation in cases of Endometriosis and ovarian tumors. It is the fastest way of carrying out tubal ligation and is effective for diagnosing certain infertility cases