Endoscopic Procedures

Endoscopy is the general name of applications for imaging the body and hollow organs with light and camera-equipped special devices. Endoscopic applications are divided into two as laparoscopy and hysteroscopy.



Laporoscopy is used for observation of the abdomen and related surgical applications, hysteroscopy is used for observation of uterine inside and surgical applications in this organ. Especially in operative applications, there are advantages such as the risk of damaging the tissues and organs, the risk of infection, the ease of operation, the low feeling of pain after the operation and the absence of surgical marks compared to open surgeries. However, in large cases and in large cases such as myoma and ovarian cancer, open surgery is still preferred.
 

Laparoscopy

The laparoscopy procedure is divided into two groups as diagnostic and operative (surgical) according to the indications. The procedure is performed under sterile operating room environment and general anesthesia in order to intervene in the abdomen if there is a need to open holes in the abdomen.

For the procedure, the abdomen is inflated with the carbon dioxide gas supplied to the abdominal cavity through a thin needle. A small incision (about 1 cm) below the umbilicus is then placed in the trocar tube, which allows the camera imaging device to enter the abdomen. The condition of the organs is examined by the light camera device which passes through this tube to the abdominal cavity. If an operative procedure is planned, 3-4 more trocar pipes can be placed to insert the necessary tools for the operation. At the end of the inspection or operation, the devices are removed and the process is completed by stitching the cuts after the gas is completely emptied.

Hospitalization time after laparoscopy is quite short and can be discharged on the same day. The patient can return to normal life in diagnostic applications and the next day in operative applications and in 7-15 days.

 

Diagnostic Laparoscopy

• In infertile patients whose examination and ultrasound findings do not show any abnormality in HSG, diagnostic laparoscopy often does not have a different finding. It is very useful in diagnosing the following problems:
• Abdominal adhesions
• Congestion in tubes
• Suspicion of endometriosis
• Chronic pelvic pain (region of the pelvis)
• Pelvic masses
• Anatomic abnormalities

 

Operative (Surgical) Laparoscopy

• Laparoscopic operations in infertile patients are successfully applied for the following indications:
• Opening of intraabdominal adhesions (Adezyolizis)
• Endometriosis (According to the degree of cauterization or excision)
• Aspiration of ovarian cysts
• Removal of myomas (Myomectomy)
• Endometrioma (Chocolate cyst)
• Ectopic pregnancy (Salpingostomy)
• Ovarian torsion
• Tube removal (Salpenjectomy)
• Opening of connected or obstructed tubes (Tubal reanastomosis)
• Uterine perforation
• Anatomical disorders (uterine suspension)

 

Hysteroscopy

The hysteroscopy procedure is divided into diagnostic and operative (surgical) according to the application indication. Diagnostic hysteroscopy (also known as office hysteroscopy) can be performed by local anesthesia in the surgery environment, and operative applications are preferred in the operating room environment and by general or spinal anesthesia. The procedure is performed several days after the end of menstrual period, as the patient will be sure that the patient is not pregnant and yet the inner wall of the uterus (endometrium) will be quite thin and the possible abnormalities will be detected.

The imaging device (hysteroscope) used for the procedure is very thin (5mm) and is usually painless since it is inserted through the cervix. Nevertheless, it may sometimes be necessary to use drugs with a relaxing effect on the cervix to facilitate passage. Again for this purpose can be used thin long bars called the spark plug during the process. The gynecological examination position of the patient through the hysteroscope device is accessed through the cervix and the uterus is reached and after the enlarged carbon dioxide or fluid is expanded sufficiently, the uterus is examined and examined. At the end of the examination, after the gas or liquid in the uterus is emptied, the procedure is completed.
The duration of discharge after hysteroscopy is quite short. The patient may be discharged for 1-2 hours in diagnostic applications and mostly in the following day and may return to normal life.
 

Diagnostic Hysteroscopy

In order to detect a possible abnormality in the uterus, the following indications apply;

• Excessive or irregular menstruation
• Recurrent abortions
• Intrauterine adhesions (Asherman's syndrome-uterine synechia)
• Susceptibility of intrauterine polyps, uterine fibroids during ultrasound examination
• Repeated failed tube baby trials
• Intrauterine spiral or foreign matter removal
• Examination of the uterine duct

 

Surgical Hysteroscopy

• It is applied with the aim of correcting the following intrauterine abnormalities as determined by diagnostic investigations (HSG, H / S, ultrasound):
• Myoma removal (Myomectomy)
• Polypectomy
• Opening of intraabdominal adhesions (Adezyolizis)
• Uterine septum removal (innate, intrauterine curtain tissue)
• Treatment of internal vascular disorders