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Introduction to uterine cavity surgery

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Hysteroscopy has evolved during the past century to become the gold standard for investigating the uterine cavity, and is also a very useful instrument for surgery. Hysteroscopy is generally safe and efficient.

Other advantages include relatively low cost to the healthcare system and convenience to the patient as even surgical procedures can be performed on an outpatient or day-case basis.

The complication rate is low, whether hysteroscopy is used as a diagnostic or therapeutic tool; however, in rare cases the procedure can be life threatening. Appropriate training combined with understanding of the technique, equipment and indications are key for the safe and efficient utilisation of this useful tool.

Learning objectives

When you have completed this tutorial you will be able to:

  • recognise the normal and abnormal appearance of the uterine cavity
  • have a fair understanding of the instruments used in both diagnostic and operative hysteroscopy
  • understand the indications and technique of diagnostic hysteroscopy
  • understand the indications and limitations of outpatient hysteroscopy
  • understand the indications and technique of operative hysteroscopy
  • be familiar with the main hysteroscopic procedures including:
    • hysteroscopic polypectomy
    • hysteroscopic myomectomy
    • endometrial ablation
    • hysteroscopic adhesiolysis
    • metroplasty
    • hysteroscopic sterilisation
  • be aware of the complications encountered during hysteroscopic surgery and ways to prevent and manage them

Last updated: 22/01/10 (images showing the Classification of submucus fibroids and the Treatment for Asherman replaced with new, higher quality versions)

1/07/09 (WHO surgery checklist added in Preliminary reading)

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