Endoscopy- Introduction

Endoscopic methods (laparoscopy and hysteroscopy) are valuable tools in the diagnosis and treatment of infertility. Endoscopic (hysteroscopic-laparoscopic) surgery, by widening its range of application, has evolved into the treatment of choice for infertility cases, while it tends to minimize the indications for traditional laparotomy.

Hysteroscopy allows us to view the cavity of the uterus, i.e. the location that will receive the developing embryo and will support its development. Laparoscopy is useful for examining the internal female reproductive organs (i.e. uterus, fallopian tubes and ovaries). Salpingoscopy allows us to view the intraluminal portion of the uterine tubes, although this method was not widely accepted, it is rarely used and is not part of everyday clinical practice.

Some pathological conditions of female genital organs cannot be diagnosed with any other method but by hysteroscopy (e.g. endomitritis) or laparoscopy (e.g. peritoneal endometriosis or adhesions). It is possible that these conditions remain undiagnosed for a long time period in a significant percentage of infertile women. Many of these conditions can be identified and treated during the same operating procedure under anaesthesia.

A main principle of endoscopy is the ability for immediate visualisation of the formations and colorations of the human body cavities with a minimum amount of distortion (J. Hamou). Experience and knowledge in this field are necessary, as well as the right selection of technical equipment. The selection of the cold light laparoscope, the camera and the tools used reflect the experience of the surgeon. There are many differences in the various types of equipment that are used and it is very important to make the best selection.

Hysteroscopic and laparoscopic surgery represent a technological revolution in surgery. The surgeon and his colleagues operate by viewing the image on the monitor via a camera attached to the laparoscopy probe. Laser beams, electrosurgery units, numerous special tools and endoscopes comprise the technological equipment used. As well as specialized scientific knowledge and experience, the surgeons must have a sound technical knowledge of the special equipment.

Pregnancy rates are significantly higher following hysteroscopic correction of pathological conditions of the uterine cavity.