Hysterolaparoscopy

Laparoscopy is an operation performed in the abdomen and pelvis through a small incision  (usually 0.5–1.5 cm) with the aid of a camera. It can either be used to inspect and diagnose a condition or to perform surgery.

Hysterolaparoscopy is a procedure in which hysteroscopy and laparoscopy are performed in combination in the same sitting. Hysterolaparoscopy is more beneficial as the diagnosis of the problem and treatment can be done at the same sitting. This helps take the decision for artificial reproductive techniques during the evaluation itself (Vaid 2014).

Procedure -In a Hysteroscopic procedure doctor uses a thin viewing tool called a hysteroscope. The tip of the hysteroscope is put into your vagina and gently moved through the cervix into the uterus. The hysteroscope has a light and camera hooked to it so your doctor can see the lining (endometrium) on a video screen and laparoscopy allows doctors to perform both minor and complex surgeries with a few small cuts in the abdomen to visualize inside the abdominal cavity or to perform any surgical procedure.

Why performed? 

It is useful for diagnosis, treatment, or both. A diagnostic procedure can sometimes turn into a treatment.

Some reasons for diagnostic  Hysterolaparoscopy are:

• Find the cause of severe cramping or abnormal bleeding. Your doctor can pass heated tools through the hysteroscope to stop the bleeding.
• See whether a problem in the shape or size of the uterus or if scar tissue in the uterus is the cause of infertility.
• Look at the uterine openings to the fallopian tube. The fallopian tube blockage opened using specialized instruments.
• Find the possible cause of repeated miscarriage. 
• Find and remove a misplaced intrauterine device (IUD)
• Find and remove small fibroid or polyps.
• Check forendometrial cancer.
• Use heated tools to remove problem areas in the lining of the uterus (endometrial ablation).
• Place a contraceptive implant (such as Essure) into the opening of the fallopian tubes as a method of permanent sterilization
• Unexplained pelvic pain
• Unexplained infertility
• A history of pelvic infection
• Torsion Ovarian cyst
• Simple or complex ovarian cyst
• PID

Hysterolaparoscopy helps in the diagnosis of the following conditions:

• Endometriosis
• Septated uterus
• Blocked fallopian tube
• Uterine fibroids
• Ovarian cysts or tumors
• Ectopic pregnancy
• Pelvic abscess, or pus
• Pelvic adhesions, or painful scar tissue
• Infertility
• Pelvic inflammatory disease
• Reproductive cancers

How To Prepare

Tell your doctor if you:

• Are or might be pregnant.
• Are taking any medicines.
• Are allergic to any medicines.
• Have had bleeding problems or take blood-thinners, such as aspirin or warfarin).
• You have taken treatment for any vaginal, cervical, or pelvic infection in the preceding last 6 weeks
• Have any heart or lungs

Preparation

Surgery 

If the procedure is planned in the hospital under general anesthesia, then the patient is asked not to eat or drink (fluid) anything (not even water) eight hours (generally midnight prior to surgery) before the procedure.

Aftercare

Many women experience light bleeding for several days after surgical hysteroscopy. Mild cramping or pain is common after operative hysteroscopy but usually fades away within eight hours. The carbon dioxide gas used for insufflation may cause some mild shoulder pain after the surgery. Non-prescription pain relievers may help ease discomfort. Women may want to take the day off and relax after having a hysteroscopy.

Risks

Diagnostic hysteroscopy is a fairly safe procedure that only rarely causes complications. After removal of any growth, there may be a risk for prolonged bleeding or infection.

Very rare complications include perforation of the uterus, bowel, or bladder. Surgery under general anesthesia causes the additional risks typically associated with anesthesia.

Patients should alert their health care provider if they develop any of these symptoms:

• abnormal discharge
• heavy bleeding
• fever over 101 °F (38.3°C)
• severe lower abdominal pain