Hysteroscopy is the inspection of the uterine cavity by endoscopy. Allows the diagnosis of intrauterine pathology and serves as a method of surgery (hysteroscopy). br The hysteroscope is a long tube, about the size of a straw, which is incorporated into a display device. Hysteroscopy is useful for diagnosis and treatment of some problems that cause infertility, miscarriages, and abnormal menstrual bleeding. Sometimes, other procedures such as laparoscopy, are made at the same time as hysteroscopy. br The hysteroscope is an optical instrument connected to a video unit with a light source fiber optic, and channels for delivery and pickup of a distension medium. The uterine cavity is a cavity potential and needs to be stretched to permit inspection. Thus during hysteroscopy either gas or liquid CO2 is introduced to enlarge the cavity. The choice depends on the procedure and the patient's condition. Liquids can be used for diagnostic and operative procedures. However, the CO 2 gas does not allow the purity of blood and endometrial debris during the procedure, which could make it difficult to display images. Gas embolism as a complication may also arise. Given the success of the procedure is completely dependent on the quality of highresolution images of video before the eyes of the surgeons, the CO2 gas is not used as a means of relaxation. Electrolytic solutions include normal saline and Ringer's lactate. The current recommendation is to use the liquid electrolyte in the case of diagnosis, and in cases of failure that uses mechanical laser or bipolar energy. Since they are conducting electricity, these liquids should not be used monopolar electrosurgical devices. No liquid electrolyte eliminate problems with the electrical conductivity, but may increase the risk of hyponatremia. These solutions include glucose, glycine, dextran (Hyskon), mannitol, sorbitol and mannitol mixture sorbital (Purisol). The water was used routinely, however, problems with water intoxication and hemolysis discontinued use in 1990. Each of these liquids is associated with physiological changes unique strain that must be considered when selecting a distention fluid. Glucose is contraindicated in patients with glucose intolerance. Sorbitol to fructose is metabolized in the liver and is contraindicated if the patient is intolerant to fructose. High viscous dextran also the possible complications that may be physiological and mechanical. Instruments can crystallize and clog the valves and channels. Coagulation and acute respiratory distress syndrome (ARDS) have been reported. Glycine metabolizes into ammonia and can cross the bloodbrain barrier, causing restlessness, vomiting and coma. Mannitol 5% should be used instead of glycine or sorbitol using monopolar electrosurgery devices. Mannitol 5% have a diuretic effect and can also cause hypotension and circulatory collapse. The mixture of sorbitol mannitol (Purisol) should be avoided in patients with fructose intolerance. br A hysteroscope is actually a modification of the traditional resectoscope, which is used for transurethral resection of the prostate. Double case has a channel that allows continuous flow of liquid or gas media in the uterus through the larger channels, while allowing less output through small channels. This results in distension of the uterine cavity. With modern optical technologies, hysteroscopes are getting smaller in diameter yet able to provide images larger and brighter convenience to surgeons. br After cervical dilation, the hysteroscope is guided into the uterine cavity and carried out an inspection. If anomalies are found, a hysteroscope for cooperation with a channel to allow specialized instruments to enter the cavity is used to perform the surgery. Typical procedures include endometrial ablation, resection of submucosal fibroids and endometrial polypectomy. Typically hysteroscopic intervention is done under general anesthesia or monitored anesthesia endotracheal Care (MAC), but a short diagnostic procedure can be performed in a gynecologist's office with only a paracervical block by injection of lidocaine in the upper cervix. br br
