Basic Equipment for Diagnostic Hysteroscopy
Linda D. Bradley
General Principles
Definition
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Hysteroscopy is a minimally invasive transcervical procedure to provide panoramic visualization of the vagina, endocervix, endometrial cavity, and tubal ostia.
Imaging, Instruments, and Equipment
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The basic hysteroscope may be flexible or rigid and is connected to a light source. It has an ancillary port to which distention fluid or CO2 is used to distend the uterine cavity. A camera is frequently attached to the lens. When a video tower system is available, both the patient and nursing staff can be engaged in the procedure.
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In addition to an inflow tract, some hysteroscopes have an outflow tract.
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Hysteroscopes have variable lens ranging from 0, 12, 15, 30, to 70 degrees.
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There are variable diameters of diagnostic hysteroscopes available ranging from 2.9 to 10 mm (Fig. 3.1).
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The most comfortable hysteroscopic diameters for office use are 4 mm or less. They usually require minimal or no cervical dilation.
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Rigid hysteroscopes have a rod lens and offer the clearest view.
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Flexible hysteroscopes incorporate a distal tip that is flexible and defects over a range of 120 to 160 degrees (Fig. 3.2). They utilize a fiber optic or digitally enhanced lens system.
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The flexible hysteroscope has the smallest diameter compared to a rigid system. Its lens is 0 degrees.
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Several benefits of the flexible hysteroscope include:
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A longer working length which is ideal for obese women who may have a longer vaginal length.
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