What is hysteroscopy and how is it done

VIDEO: Entrance of the hysteroscope in the uterine cavity. The openings of the fallopian tubes can clearly be seen. Normal uterine cavity.

For hysteroscopy, the distention of the uterus is necessary. This is achieved with the use of CO2 gas or a normal saline solution which is introduced in the uterine cavity through a special sheath system that is attached to the hysteroscope.
The sheath system may be diagnostic or operative and smaller tools (scissors, forceps, small electrodes) may pass through it.
Modern sheath systems can offer a constant flow, which is important for maintaining a clear view, which is in turn essential for performing any hysteroscopic surgery. Thus, operative sheath systems of constant flow are used for such procedures.
The hysteroscope is connected with a cold light source (Xenon) with a special optical fibre wire.

The Xenon light source light bulb emits clear white light, at 6000 Kelvin degrees, which equivalent to the temperature of the sunlight. A very small weight camera is attached to the front lens of the hysteroscope which allows the projection of the image to a colour screen and the recording of the procedure.

Office Hysteroscopy

Office hysteroscopy can be performed at the office level without anesthesia. The same equipment as previously described is used. The main difference is the use of CO2 gas for the distension of the uterus, which is introduced in the sheath of the hysteroscope via a polyethylene tube. Using special electronic equipment of controlled CO2 flow (Hysteroflator) intrauterine pressure is preselected and gas flow is automatically adjusted. Intrauterine pressure is kept at low levels to prevent uterine contractions, as well as pain in the uterus and shoulders.
The examination is almost painless and lasts for a few minutes. Requirements for the application of the method include good expertise, technical proficiency and experience, because distension of the uterine cavity using CO2 is more technically challenging compared to the equivalent method using saline for the distension of the uterus.