Dec 11, 2018 | 755 Views
This video outlines the surgical steps in performing hysteroscopic removal of retained intrauterine devices (IUDs) in early pregnancy.
Mar 11, 2019 | 606 Views
This video presents a stepwise approach to the hysteroscopic resection of a cesarean scar isthmocele. Two cases are presented to highlight the surgical steps and technical tips in successfully performing this procedure.
Mar 11, 2019 | 244 Views
This video shows a case of hysteroscopic resection of early stage endometrial cancer.
Apr 15, 2019 | 225 Views
This video outlines a case of a 34-year-old women who underwent emergency cesarean section following the development of HELLP Syndrome. She subsequently was treated with hysteroscopic removal of retained placental tissue alleviated her postpartum hypertension.
Apr 20, 2019 | 269 Views
This video outlines the approach to the hysteroscopic management of a stenotic cervix using video from cases performed in an outpatient hysteroscopy setting.
Jul 5, 2019 | 265 Views
This video outlines the approach to the hysteroscopic lysis of adhesions performed to surgically manage Asherman’s Syndrome. This video uses case presentations and discusses a case series outlining how to manage this in an outpatient setting.
Jul 8, 2019 | 191 Views
This video outlines a classification system for intra-uterine adhesions and describes how ultrasound can be used to help facilitate lysis of adhesions by hysteroscopy.
Jul 8, 2019 | 229 Views
This video outlines an approach to set up an outpatient hysteroscopy suite and demonstrates hysteroscopic procedures, describes vaginoscopy, and provides an overview of analgesia protocol.
Jul 12, 2019 | 221 Views
This video describes a case in which retained placental tissue was hysteroscopically removed, resolving postpartum hypertension.
Sep 26, 2019 | 200 Views
Deep subendometrial fibroids represent a technical challenge for complete hysteroscopic removal. Such fibroids include deep type II submucosal fibroids, type III fibroids (intramyometrial abutting the endometrium), and hybrid stage II-V fibroids (intramyometrial extending in both directions, submucosa and subserosa) according to FIGO classification.This video demonstrates a case of a 34 year old female who had failed several embryo transfers with good quality blastocysts. After comprehensive testing for her recurrent implantation failure, the sole finding was a 2.3cm posterior wall, upper cavity, sub-endometrial fibroid 3mm from the serosa.The video presented captures the hysteroscopic removal of this 2.3cm intramural posterior wall fibroid in the upper cavity abutting and subtly elevating the posterior endometrium. The clip demonstrates the complete and safe removal of this technically challenging myoma, while offering some surgical tips. Following her myomectomy, the patient conceived after a subsequent embryo transfer and had a full-term caesarean delivery.
Sep 26, 2019 | 328 Views
The objective of this video is to review a technique for the hysteroscopic resection of Type 2 uterine fibroids. This is an educational video review featuring a case patient. Visual identification of fibroid type, surgical technique, and perioperative considerations are discussed. Gynecologists frequently perform hysteroscopic fibroid resections; however, Type 2 fibroids present a unique challenge where long operative time, excessive blood loss and fluid absorption, incomplete resection, and uterine perforation are important considerations. Our case patient is a 35 year old G1P0A1 woman with a history of secondary infertility, dysmenorrhea and heavy menstrual bleeding. Ultrasound demonstrated a 4.0 x 4.6 x 4.3cm Type 2 uterine fibroid, with a maximal distance of 7.8mm between the outer edge of the fibroid and the uterine serosa. The hysteroscopic management of Type 2 fibroids includes perioperative optimization, including preoperative planning and medical optimization. Ultrasound images should be reviewed prior to surgery, to determine the type of fibroid and the distance to the serosa. Visual identification of fibroid type at the time of hysteroscopy is also possible by observing the angle between the fibroid at its intersection with the endometrium. The techniques demonstrated in this educational video demonstrate visual identification and hysteroscopic resection of a Type 2 fibroid, including the creation of an endometrial flap overlying the defect after resection, to minimize postoperative intrauterine adhesions. In this case, resection is performed in the operating room using a monopolar resectoscope. Identification of fibroid type, including visual diagnosis, as well as attention to surgical technique and perioperative considerations, are essential for hysteroscopic resection of Type 2 uterine fibroids.
Sep 27, 2019 | 209 Views
Uterine anomalies contribute to impaired fertility, especially pregnancy loss and preterm birth. Dysmorphic uteri is a newly defined class of uterine anomalies characterized by a T-shaped cavity and hypertrophic lateral walls. Pilot studies indicate surgical correction of dysmorphic uteri may improve fertility outcomes.We show three cases of hysteroscopic metroplasty to expand dysmorphic uteri in patients with recurrent pregnancy loss. In two cases, the dysmorphic uteri were initially misdiagnosed as normal on two-dimensional ultrasound, suggesting the anomaly may be underdiagnosed. Relaxing incisions were made along the lateral and anteroposterior walls using a Collins knife. Follow-up hysteroscopic lysis of adhesions were performed as an outpatient. Follow-up three-dimensional ultrasound demonstrated expansion and normalization of the uterine cavity. Dysmorphic uteri are an under-recognized cause of impaired fertility and surgical management may improve fertility outcomes. These cases demonstrate the importance of accurate diagnosis to facilitate appropriate treatment options.
Sep 28, 2019 | 305 Views
The surgical correction of a complete uterine and cervical septum. 1. Overview of the background, clinical presentation and relevant pre-operative planning.2. An illustration and instruction for surgical correction.3. Discussion of the post-operative care and long-term outcomes.
Sep 24, 2020 | 48 Views
This video abstract demonstrates simultaneous use of pelvic ultrasound and hysteroscopy to access an ablated endometrial cavity. Endometrial ablation is commonly used to treat abnormal uterine bleeding. It can cause cervical stenosis and adhesions inside the endometrial cavity creating future challenges in accessing the cavity. Failure of endometrial sampling following endometrial ablation is found to be 23 to 26%. This video demonstrates that ultrasound-guided hysteroscopy on a scarred and distorted endometrial cavity is safe and cost efficient. It facilitates access into the uterine cavity and prevents false passage and uterine perforation.