Lap. Hysteroscopy
Dr. Anushree Pande at Pande Multispeciality Hospital, Saharanpur performs Lap Hysteroscopy - a procedure that allows her to look inside your pelvis, to analyze fallopian tubes, ovaries and uterus (womb). What is hysteroscopy? - Hystero means uterus and scopy means seeing. Hysteroscopy is a procedure through which we examine the inside of the uterus, tubal openings and the lining of the uterus with the help of a hysteroscope (Telescope). A camera is attached to the hysteroscope which is inserted inside the uterine cavity through the vagina.
It is generally done under anaesthesia. It can also be carried out as day surgery procedure. Hysteroscopy is an excellent mode of intervention to diagnose and correct any pathology within the cavity of uterus. We at Pande multispeciality hospital,Saharanpur are well equipped with the german hysteroscope-for both diagnostic and operative procedures. All Hysteroscopy surgeries are video recorded and discussed with the patient.
Hysteroscopy can be of 2 types
DIAGNOSTIC HYSTEROSCOPY
When you want to know the cause of various problems like
• Heavy menstrual bleeding
• Scanty menses
• Bleeding between periods(polyps)
• Not having periods at all(asherman syndrome)
• Infertility-to find out the cause
OPERATIVE HYSTEROSCOPY
Once a diagnosis has been made, the hysteroscope can also be used in the treatment of the problem. For example, problems that can be treated during a hysteroscopy are:
• Removal of fibroids (growths in the uterus which are
not cancer)-type 0 and 1 submucous fibroids can be removed via hysteroscope.
• Removal of polyps these may cause bleeding between periods and infertility.
They can easily be removed with hysteroscope
• BLOCKED tubes If on HSG,we find blockage at the cornual end of uterus,then a thin wire is inserted through the hysteroscope and opening of the tubes can be attempted from the proximal ends.
• Removal of displaced intrauterine contraceptive(IUCD) if the IUCD thread is not seen from below,then a hysteroscope can be used to remove the IUCD.At our centre we have successfully removed many displaced IUCDs.
• Ashermans syndrome/Intrauterine adhesions sometimes patient presents with complains of not having periods and is not able to conceive. In such cases the adhesions inside the uterine cavity are incised with the help of Hysteroscopic scissors.
• Intrauterine septum presence of a septum or a wall inside the uterus might result in difficulty in conception or recurrent abortions. In such cases, hysteroscopy is performed to cut the septum using scissors/resectoscope.
• Investigation of vaginal bleeding after menopause/Endometrial biopsy In case a patient comes with bleeding per vaginum once she has achieved menopause or a patient has complains of abnormal uterine bleeding, then we recommended getting an endometrial biopsy done via hysteroscope. This is an office procedure and is painless.
Is there any alternative to doing hysteroscopy?
Although ultrasound is a very useful technique that helps in diagnosing, it is sometimes not possible to have a clear view or the ultrasound scan may show something abnormal. In these cases a hysteroscopy is recommended.
How is hysteroscopy done?
Hysteroscopy is minor surgery that is done in an operating room. It is performed under local or general anaesthesia. The cervix is widened (dilated) and a telescope is passed to look at the inside of the uterus. As the uterus is usually ‘folded up’, a saline fluid is introduced to ‘open up the womb’ so that the doctor can have a clear and direct view of the inside of the womb. This procedure does not involve any cuts or stitches to the abdomen.
How long does it take to do the procedure?
It takes approximately 10 to 20 minutes but in case of operative intervention,it can be as long as an hour also.
If you have any query regarding the procedure/pros and cons, pls contact Dr Anushree Pande at Pande Multispeciality Hospital, Saharanpur. She will guide you in the best possible way.
Ectopic Pregnancy
Laparoscopic Management of Ectopic Pregnancy -
An ectopic pregnancy is a pregnancy that occurs outside the uterus. Dr. Anushree Pande is an expert of laparoscopic management of ectopic pregnancy at Pande Multispeciality Hospital in Saharanpur and nearby. The word “ectopic” means misplaced. So a pregnancy which is implanted outside the uterus (which is the normal site of implantation), is called an ectopic pregnancy. The incidence is almost 1-2% of all normal pregnancies. 90 percent occur in the tubes but can also occur in the ovary/cervix/abdomen.
Laparoscopic surgery is used to treat some ectopic pregnancies. In this procedure, a small incision is made in the abdomen, near or in the navel. Next, Dr. Anushree Pande uses a thin tube equipped with a camera lens and light (laparoscope) to view the tubal area.
What is normal pregnancy?
In normal conception, the egg is fertilized by the sperm inside the fallopian tube. The resulting embryo travels through the tube and reaches the uterus 3 to 4 days later. However, if the fallopian tube is blocked or damaged and unable to transport the embryo to the uterus, the embryo may implant in the lining of the tube, resulting in an ectopic
What happens if the pregnancy happens inside the fallopian tube?
The fallopian tube cannot support the growing embryo. Sadly, there is no possibility that your pregnancy can survive. After several weeks the tube can rupture and bleed, resulting in a potentially serious life threatning situation.
The loss of your pregnancy is likely to make you feel very sad. Also this may be the first time you have heard of this condition and you may also feel shocked, confused and anxious about the future.
Who can develop an ectopic pregnancy?
Ectopic pregnancy can occur in any sexually active woman. The chance is higher in cases :
• History of a previous ectopic pregnancy -then you have a slightly higher chance that a future pregnancy will be ectopic.
• If the fallopian tubes are damaged or abnormal as a result of infection(pelvic inflammatory disease). This is because a fertilised egg (ovum) may become stuck in the tube more easily. The tubes can also be damaged due to previous surgery/endometriosis,previous sterilization operation.
• If you use an intrauterine contraceptive device(copper-t/multiload),then pregnancy is rare as this is a very effective method of contraception. However, if you become pregnant while using an IUCD, the pregnancy has a higher chance of being ectopic than if you did not have the IUCD.
• Women who conceive using fertility drugs/IVF treatment.
What are the symptoms of ectopic pregnancy?
Symptoms of an ectopic pregnancy can often be vague, and so difficult to diagnose because they often mirror those of a normal early pregnancy.
• Missed or late periods
• irregular vaginal bleeding
• Abdominal Pain
• Sharp pain in the abdomen or pelvis which can be intermittent or
constant.
• Dizziness or fainting
How to diagnose an ectopic pregnancy?
A pregnancy test should be done as soon as you have missed your periods.
Visit your gynaecologist if you have symptoms of pain,who would do a pelvic examination. An ultrasound may help in identifying a sac in the fallopian tube and uterus would be empty. If the pregnancy is less then 6 weeks, it may be very hard to diagnose an ectopic pregnancy. In such cases, repeated blood tests (bhcg) are done to check hormone levels.
In ectopic pregnancy the levels are usually lower and rise more slowly.
What is the treatment of ectopic pregnancy?
Treatment depends on the situation and symptoms as presented by the patient.
Early ectopic pregnancy - before rupture
Ectopic pregnancy is most often diagnosed before rupture. Dr Anushree Pande at pande hospital is a very well read gynaecologist who will discuss all the treatment options with you and, in many cases, you are able to decide which treatment is best for you. These may include the following:
• Surgery. Removal of the tube. We at Pande multispeciality hospital are experts in managing ectopic pregnancy by keyhole surgery (a laparoscopic operation). Removal of the Fallopian tube containing the ectopic pregnancy (salpingectomy) is usually performed if the other tube is healthy laparoscopically.
• Medical treatment. Medical treatment of ectopic pregnancies is now an option in some selected cases that may avoid the need for surgery. It is normally only advised if the pregnancy is very early. The advantage is that you do not need an operation. The disadvantage is that you will need close observation for several weeks with repeated blood tests and scans to check if it has worked.
• Wait and see. Not all ectopic pregnancies are life-threatening. In many cases the ectopic pregnancy resolves by itself with no future problems. The pregnancy often dies in a way similar to a miscarriage. You will need close observation by your gynaecologist .Dr Anushree Pande would do repeated scans and blood tests to check on how things are developing.
Ruptured ectopic pregnancy
Emergency surgery is needed if a Fallopian tube ruptures with heavy bleeding. The main aim is to stop the bleeding. The ruptured Fallopian tube and remnant of the early pregnancy are then removed. The operation is often life-saving.
Which procedure you have depends on the amount of bleeding and damage and whether the tube has ruptured. Consult today with Best Doctor for Ectopic Pregnancy Treatment,Dr. Anushree Pande.
Hysteroscopic Polypectomy
Dr. Anushree Pande at Pande Multispeciality Hospital, Saharanpur an expert to perform Hysteroscopic Polypectomy. It is a surgery to remove uterine polyps preserving the uterus. Uterine polyps are a non-cancerous overgrowth of cells in the inner wall or lining of the uterus. Hysteroscopy is used to diagnose and treat problems of the uterus. A diagnostic equipment, Hysteroscope, is used by Dr. Anushree Pande to view the lining of the uterus. A woman usually requires this procedure for biopsy, and to remove fibroids and polyps.
The advantages of Hysteroscopic Polypectomy surgery are:
• It is not a time-consuming procedure.
• It is the only way to diagnose certain medical conditions.
• It does not involve any cuts or stitches in the abdomen.
Hysteroscopic Guided Endometrial Biopsy - It is a procedure applicable to the female and your gynaecologist Dr. Anushree Pande determines whether you need it or not. If you are suffering from an abnormal or an unusual amount of menstrual bleeding, or if you are still; bleeding even after you have hit your menopause, then these factors acts as a red flag for the procedure to be taken under. To understand the cause of the abnormalities, an endometrial biopsy is required.