Hysteroscopy in Latin describes looking into the uterus. Over the past few decades, the technology evolved into these minimally invasive telescopes called hysteroscopes.  Hysteroscopes have opened up a new dimension of treatment of uterine and endometrial disease. Traditionally, hysteroscopes were only used as diagnostic instruments in the late 80s.  With the improvement in digital technology for on-screen display of the uterine cavity and employment of bipolar technology, a field of operative hysteroscopy has evolved.  Avanced  applications include removal of the lining of the uterus called endometrial ablation as well as removal of uterine polyps, uterine fibroids and removal of scar tissue called synechiae.  In addition,  permanent contraceptive implants called Essure® and Adiana® can be placed in the fallopian tubes.  Essure® is proven to provide the highest success rate among all permanent contraception including vasectomy and tubal ligation.

Operative Hysteroscopy is the use of the hysteroscope with a working channel.  The diameter of this is 9 mm which is less than ½ inch.  These procedures are done in the operating room under a light general anesthetic which does not require intubation.  With these procedures, fibroids as large as 2 to 3 inches can be removed when they grow inside the uterine cavity and cause heavy bleeding or cramping.  In addition, endometrial ablation (destruction of the endometrium) using rollerball technique or resection can be achieved to stop heavy bleeding in patients.  Removal of uterine scars to achieve improved fertility and menstrual function called synechiae is highly successful with these procedures. 

Hysteroscopy may be added to a procedure called laparoscopy.  These procedures are commonly combined to treat patients with endometriosis, infertility, uterine fibroids or other gynecologic conditions.  Traditionally, these Minimally Invasive Surgeries are done in out-patient surgery centers or ambulatory surgery centers (ASC) with minimal anesthesia.  The patient will enter the surgery center 1 hour before and will leave approximately 1 hour after the procedure for a total duration of approximately 3 hours during the day.  They will be asked to have somebody drive them home and should not drive for the rest of the day.  Most patients can return to their normal daily activities within 24 hours.  Postoperative pain is usually limited to mild cramping which is easily treated with over-the-counter Ibuprofen or Tylenol.