Hysteroresectoscopy or surgical hysteroscopy is a medical procedure when physician examines uterine cavity from inside, and, during this procedure, carries out surgical elimination of any pathological processes in uterine cavity – removing of polyps, submucous myoma nodes, separating of adhesions, walls of the womb.
During hysteroresectoscopy, a rigid hysteroscope of small diameter is introduced through the cervix uteri canal into the uterine cavity and connected with video system and screen on which structure of uterine cavity may be examined. To make the procedure sufficiently informative, uterine cavity is expanded by filling it with warm saline liquid.
It allows physician examine and carry out surgeries in uterine cavity.
Intravenous anaesthesia is used during the procedure, and patient sleeps.
Duration of the procedure is 1- 1.5h. After surgery, patient is taken to post-surgery ward where they are monitored. In the evening of the same day, patient may leave to home, if they are accompanies by a relative, or patient is discharged the next day after surgery.
About 1-2 weeks after surgery, bloody and watery discharge may be observed from vagina. Sex life shall be refrained during this period.
Laparoscopy allows diagnostics of numerous diseases of the lesser pelvis, as well as biopsy (sampling) of the lesser pelvis organs – uterus, oviducts, ovaries – for further examinations, to exclude development of oncologic diseases in reproductive organs at an early stage.
Furthermore, during this procedure, treatment of the lesser pelvis organs, for example, separating of adhesions, removing of ovary cists, testing of oviduct permeability, etc.
Laparoscopy method uses introducing of optical medical device - laparoscope – into abdomen through abdominal wall. Thus, physician makes small cuts (5 – 7 mm) in the abdominal wall.
In order to have better view, abdominal cavity is filled with carbon dioxide. Laparoscopy is carried out under endotracheal anaesthesia where patient is in deep sleep and feels nothing.
Duration of the surgery is 1 - 2,5 hours. Stitches (if any) shall be removed on the 5th – 6th day after the surgery.
PREPARATION FOR SURGERY
- When you go to the hospital, take with you a passport, a family doctor's appointment (if any), a policy, if any, and all recent tests and medical examinations, as well as regularly taken medicines.
- Leave home ring and jewelry when you go to the hospital. Just bring the necessary things only – a toothbrush with a toothpaste, towel, bathrobe, slippers and a bottle of water to the hospital Just bring the necessary things only – a toothbrush with a toothpaste, towel, bathrobe, slippers and a bottle of water to the hospital. In the hospital, all patients are given a clean, stylish, long-sleeved shirt, wherein patients go to the operating room.
- PBefore the surgery it is preferable to purchase “ISLA” Icelandic lichen to be used after the surgery operation period, as upon awaking up it can be itchy in the throat and suckling lichen tablets help in this case.
- You are allowed to take phones and computers with you. During the surgery operation they can be handed over to the head nurse of the department.
- Ask your doctor if you need a flexible belt after the surgery.
- Prepare the intestinal tract before surgery. A day before being admitted at the hospital at 8:00, eat a light breakfast (cottage cheese, porridge, yogurt) and starting from 12:00 no longer eat. A day before the surgery, drink 2 doses of castor oil - 15 ml (one tablespoon) at 12:00 and 15ml (one tablespoon) at 13:00.
- Remember to take your pharmaceutical drugs if you have been prescribed last night before the surgery.
- Take a shower in the evening before the surgery operation.
- Shave on the area of the pubic hair and lower the abdomen in the morning on the day of surgery.
- Clean the cosmetics upon arrival to the surgery operation.
- Remove the chewing gum, contact lenses, and dentures when you go to the surgery.
- Stop taking Aspirin 3 days before the surgery.
- Continue to take insulin and hypoglycemic agents as directed by your therapist if you are a diabetic patient. Take your insulin and hypoglycemic drugs with you.
- Patients taking anticoagulants or other specific therapies should continue to take the medicines as recommended by the therapist.
- Do not take blood pressure regulation medicines in the morning of surgery but take them to the hospital.
NECESSARY MEDICAL EXAMINATION AND ANALYSES
Medical examination is required prior to the surgery (original forms, the examination is valid for 30 days):
- Complete blood analysis picture;
- blood sugar level, urea, creatinine, AST, ALAT, bilirubin, antiHIV, HBsAg, antiHCV;
- prothrombin, APTL;
- urine analysis;
- ECG (electrocardiogram) with description and tape;
- Rh factor, blood group, antibodies;
- USG for small pelvic organs;
- cervical oncocytological swab;
- Covid-19 test (valid 48h before surgery).
In the morning of the day of surgery, consultation with anaesthesiologist will take place. We recommend trying to remember the most significant facts related to your health, telling about former anaesthesia experience, and any drug intolerance already before this conversation. It is important to remember and know name of the medicinal product that has caused issues, in particular, if this intolerance has been severe – with oedema, shortness of breath, rash, even loosing of consciousness.
You must tell to the physician if you have a root abscess or any other inflammation process. It must be treated before surgery. Anaesthesiologist shall know if the patient suffers from any cardiac or vascular disease, if they have not suffered from cold recently. Patient must notify what medications have been used daily.
PLACE OF SURGICAL OPERATION
The surgical operations are carried out at Adazi Hospital at 13/15 Gaujas Street, Adazi. Comfortable conditions are provided at the hospital, wards are with all up-to-date conveniences and attentive, friendly medical staff.
Immediately after surgery, patient is taken to the ward where they wake up slowly and may get up already in couple of hours.
When using narcosis, patient sometimes may experience nausea, vomiting after surgery. You must tell your doctor or nurse about any unpleasant feeling, for example, pain, breathing difficulties, numbness or vision disorder.
When you wake up from anesthesia, you should go to the facilities to urinate as soon as possible. The patient can go home only on condition that this is done.
When patient is allowed to drink, they shall use sufficient volume of liquid.
After manipulations, you may feel pulling pain in the lower part of abdomen, and you may experience light bleeding. Bleeding usually is light and disappears within a week.
On the surgery day, you may not drive. If patient is discharged home on the day of surgery, if possible, they shall spend the entire day (up to the next morning) in presence of their relatives. On the surgery day, going by public transport or walking along the street is allowed only together with a companion.
During the first days, if there is pain, physician will prescribe anaesthetics, however, the pain is usually insignificant. There is no specific restriction concerning diet. After surgery, patient may sometimes experience metabolism, thus, first 3 – 4 days we recommend soft diet – to eat something more liquid – soups, porridges and steams.
A little discomfort remains for the next few days after the surgery, sometimes accompanied by discomfort in the shoulder area due to gas irritation applied to the diaphragm during the surgery, but it disappears in the next few days. Analgesics usually help in such cases.
During recovery period, we recommend choose more cautious rhythm without any physical load for 2– 4 weeks. After a month, you may gradually return to physical activities, go to sauna etc. No specific rehabilitation required.
After the surgery, the patient should arrive at 5-7th day to replace bandage at the surgery wound. During the visit, threads are removed, and obscure questions are clarified once again.
REMOVED SURGICAL MATERIAL
After the operation, the entire surgery material is sent to the Academic Histology Laboratory at 45, Ilukstes Street, Riga, where the healthcare professionals-pathologists investigate the tissues removed during surgery. The study takes place regardless of the fact whether there have already been morphological (histological) analyzes or not.
In all cases, the material is re-examined and a morphological (histological) response is received approximately within a week.
After receiving a histological response, the patients are provided with extracts, which are sent to the specified e-mail address or are available at the doctor during the visit.
If necessary, for all types of operations we prepare additional explanations for insurance companies so that the insurance company can cover expenses of the patient or issue a letter of guarantee.