[Clinical study on 235 cases performed under hysteroscopy combined with laparoscopy]

OBJECTIVE: To evaluate the clinical value of using hysteroscopy combined with laparoscopy in gynecologic disease. METHODS: From January 1995 to January 2001, two hundred thirty five operations were performed under hysteroscopy combined with laparoscopy. This paper focuses on their indications, method and complications as well as management. RESULTS: Among the 235 cases, all of them were performed more than two procedures inside uterine and pelvic cavity. Hysteroscopy underwent on all cases for the lesion of uterine cavity except one changed laparotomy due to heavy bleeding. These hysteroscopy included some complicated operations such as transcervical resection of septum, transcervical resection of adhesion, transcervical resection of embryo bones and IUD pieces embedded endometrium as well as transcervical resection of myoma that the size was bigger than 4.5 centimeter or intramural and broad peduncle one. Seven cases with incomplete uterine perforation and three cases with uterine perforation were found by laparoscopy during hysteroscopic procedures and treated under laparoscopy. In addition, other laparoscopic procedures such as cystectomy, adhesiolysis, myomectomy, hydrotubation, salpingostomy and oophorectomy etc. Were also performed. There were no complications caused by hysteroscopy combined with laparoscopy. CONCLUSIONS: Hysteroscopy combined with laparoscopy can be performed under one anesthesia and managed the lesions in both uterine and pelvic cavity that could not be treated previously with single hysteroscopy or laparoscopy. Hysteroscopy combined with laparoscopy can find out and treat uterine perforation timely and reduce complications.