Ultrasonographic versus laparoscopic control of hysteroscopic surgery

ABSTRACT

This study was carried on 38 patients attending in Benha UniversityHospitals with different pathological intrauterine lesions that needed hystroscopic surgery. The patients were divided into two groups A and B. Group A consists of 28 patients in whom transabdominal ultrasound was used as a control for the hysteroscopic surgery [17 endometrial resections, 5 myomectomies, 4 resections of uterine septum and 2 divisions of intra-uterine adhesions]. Eight cases were done under cervical infilteration anaethesia while the others were done under general anaethesia. Group B consists of 10 patients in whom the old method of laparoscopic control under general anaethesia was used during hysteroscopic surgery [6 endometrial resections, 2 myomectomies, 1 resection of uterine septum and 1 division of intrauterine adhesions]. There were no complications in both groups a part from one perforation which needed no further management in group B due to obscuring of the field by adhesions from a previous pelvic operation. In one case of group A blanching of the peritoneal uterine coat occurred during endometrial resection but actual perforation did not occur. Ultrasound control of hysteroscopic surgery is recommended as it is easy, non-invasive has no special complications or contraindications as for laparoscopy and allows the hysteroscopic surgery to be done under local cervical anaethesia as an outpatient office procedure