Dilation and Curettage with Hysteroscopy

 

Preop Diagnosis: ***

Post op diagnosis: Same

Procedure: D & C with hysteroscopic evaluation

Surgeon: ***

Assistant: ***

Anesthesia: IV sedation

IVF: ***

EBL: ***

UOP: patient voided prior to procedure

Indication: @age@ yo @gp@ presenting with ***

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Specimens: Endocervical curettings and endometrial curettings

Findings: Approximately *** sized ***anteverted uterus was sounded to a depth of *** cm, easily serially dialted to accomodate a 5mm hysteroscope. On hysteroscopic survey, endometrial cavity appeared normal with no obvious polyps, masses or fibroids*** (if abnormal findings, describe findings). Bilateral ostia visualized

 

Procedure: The patient was met in pre-operative holding and re-consented as to the risks/benefits and indications for a hysteroscopy. She taken to the operating room where intermittent compression devices were placed she was given IV sedation. She was prepped and draped in the usual sterile fashion and placed in the dorsal lithotomy position.  A safety timeout procedure was then performed. Examination under anesthesia revealed findings as noted above. Retractors were placed in the vagina to visualize the cervix and the anterior lip of the cervix was then grasped with a single tooth tenaculum. The uterus was sounded to a depth of *** cm and then serially dilated to accommodate the hysteroscope and the uterine cavity was distended with *** with the findings noted above. The hysteroscope was then removed and then a gentle curettage of the endometrial canal was performed until good cry was noted in all four quadrants. *Following this, the hysteroscope was reinserted and no additional polypoid tissue was noted. The hysteroscope was removed*. The single tooth tenaculum was removed from the anterior lip of the cervix with good hemostasis at the site. All instruments were removed from the vagina. The patient tolerated the procedure well and was taken to the recovery room in stable condition.

 

*For Endometrial Ablation, add the following:

 

Following this the endometrial ablation was performed. The Novasure device was inserted into the uterine cavity and set to uterine size and primed. The device was initiated and a full cycle was performed lasting ***seconds. After the cycle was complete, the  device was withdrawn.