Diagnostic Hysteroscopy & Laparoscopy is done to confirm the diagnosis of proximal tubal block as blocked tube may turn out to be open in Laparoscopy with HSG reported tubal block is very common.
Patient is given general anesthesia. Patient is put on lithotomy position. Local parts cleaning & paintings with antiseptic solution & draping are done. After P/V examination cervix is checked with uterine sound.
Hysteroscopy requires distention of the uterine cavity with Normal saline to create working space inside the uterine cavity and flushes both fallopian tubes with high pressure fluid also helps in achieving very good fertility enhancing results following Hysteroscopy in infertility patients.
First Diagnostic hysteroscopy is done after removing the air from sheath & hysteroscope (varsascope/1.9 mm/ 2.9 mm) assembled. Hysteroscopy along with irrigation of Normal saline is introduced inside the cavity. Systemically both corneal openings, cavity, both lateral walls and anterior & posterior wall of the uterine wall is noticed for any lesions or normalcy.
Inside the Umbilicus small needle is introduced and Co2 gas is insufflated inside abdomen. Rather than creating a large incision and opening up the body, tiny incisions are made and laparoscope is inserted. This slim scope has a lighted end. It takes pictures – actually fiber optic images - and sends them to a monitor so the surgeon can see what is going on inside Performing Laparoscopy usually only requires two tiny incisions less than one half cm, (about 3-5 millimeters) in length. One incision is made inside the navel, and another is usually made near the bikini line. The first incision allows a needle to be introduced into the abdomen so carbon dioxide gas can be pumped inside the cavity of the abdomen, which helps to keep intestines & omentum up and away from pelvic organs. This allows the surgeon a better view and more working space to maneuver the laparoscope and surgical tools as needed.