Basic Equipment for Diagnostic Hysteroscopy
Linda D. Bradley
General Principles
Definition
Hysteroscopy is a minimally invasive transcervical procedure to provide panoramic visualization of the vagina, endocervix, endometrial cavity, and tubal ostia.
Imaging, Instruments, and Equipment
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.
In addition to an inflow tract, some hysteroscopes have an outflow tract.
Hysteroscopes have variable lens ranging from 0, 12, 15, 30, to 70 degrees.
There are variable diameters of diagnostic hysteroscopes available ranging from 2.9 to 10 mm (Fig. 3.1).
The most comfortable hysteroscopic diameters for office use are 4 mm or less. They usually require minimal or no cervical dilation.
Rigid hysteroscopes have a rod lens and offer the clearest view.
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.
The flexible hysteroscope has the smallest diameter compared to a rigid system. Its lens is 0 degrees.
Several benefits of the flexible hysteroscope include:
A longer working length which is ideal for obese women who may have a longer vaginal length.
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