Hysteroscopic surgery- Conditions for application

It is evident that hysteroscopic surgery application requires a great deal of experience and specialisation of the surgical ream, while it is also essential to perform a full pre-operative check along with the necessary pre-operative preparation.

The necessary medical equipment include a series of hysteroscopes, flow source, tools and cold light sources, infusion-suction devises and electrosurgery units.

However, the most important “tool” for the specialised surgeon are his/her surgery colleagues, i.e. the second surgeon participating, the experienced anaesthetist and the specialised surgery personnel. The minimum conditions that must be met in order to proceed with this surgery are a clear field of view, which is achieved with the special continuous flow sources and the maintenance of a constant intra-uterine pressure, always within the internationally accepted limits.

The Endomat electronic fluids infusion-suction device (J. Hamou invention) achieves a constant intra-uterine pressure that can be pre-selected, while it automatically regulates the infusion and suction of the fluid distention means.

The electrosurgery units are necessary tools for performing a hysteroscopic surgery and they can be monopolar or bipolar. The bipolar electrosurgery units (Versapoint) are the modern approach since they provide safety of the bipolar current and the possibility to use the safe saline solution versus the non-electrolytic colloid solutions (glycine, sorbitol) which have side-effects.

Hamou, who was one of the pioneers of hysteroscopic surgery, considers that the minimum conditions that must be met are a very good knowledge of:

  • The techniques of diagnostic hysteroscopy,
  • The capabilities and limitations of the all tools and units used,
  • The indications, contra-indications and complications of the method
  • The various distension means of the uterus and their side-effects,
  • The capabilities and complications of electrosurgery.