It is a minimal invasive surgical procedure done with the help of general or regional anaesthesia to correct the causes of infertility. The main principle of this technique is to remove the endometrium to a depth of 3-5mm.
Prior to the surgical procedure, medical history, drug allergy history, routine blood tests, history of familial diseases are noted. Patient should be in proliferative stage, ie in the mid of the menstrual cycle as the uterus lining will be thin and light in color. The patient is made to lie in the lithotripsy position, and the paracervical block is given under the general anesthesia. The cervical dilation is done by stretching the diameter of the cervix with the series of dilators. Then after the dilatation, the hysteroscope with the sheath is inserted for inspection. During this dilatation, fluids or carbondioxide gas is introduced to dilate the cavity. If any structural changes are found then operative hysteroscopy is introduced and the surgery is performed.
Contraindications includes pelvic infections, pregnancy, cervical stenosis, cervical cancer and cardiopulmonary diseases.
Complications of operative hysterectomy includes the uterine bleeding which may lead to hemorrhagic shock, fluid overload, pulmonary edema, cerebral edema, decrease in sodium levels, ammonia toxicity due to high glycine absorption, neurological symptoms, uterine perforation and injury to the other associated organs.
The most common hysteroscopic surgery for infertility are