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Hysteroscopic Surgery

Dr. Oktay is also an expert in hysteroscopic surgery whereby  conditions such as intrauterine fibroids, polyps, intrauterine scars and uterine septum can be treated by a simple outpatient telescopic approach.

Removal of intrauterine fibroids (submucosal leiomyomas, hysteroscopic myomectomy)

Sometimes fibroids growth into the uterine cavity causing infertility, recurrent pregnancy losses or bleeding problems. Instead of a complicated open surgery, these can be removed via a hysteroscopic procedure (hysteroscopic myomectomy). This is performed using a telescopic device with diameter usually less than an inch, and introducing instruments through this telescopic device under video guidance. A distention fluid typically normal saline or glycine is used depending on whether electrical devices are used, to be able create operating and visual space in the cavity. Procedure usually takes less than an hour and is a same day procedure. If there are extensive resections, sometime a balloon is left in place for about a week and estrogen treatment is given to avoid scar formation inside the uterine cavity.

Hysteroscopic Polypectomy

Uterine polyps are benign finger like growths of the endometrial lining in the cavity. Polyps have been found to cause infertility and may need to be removed if unable to conceive and there are no other obvious causes. This can simply be achieved by a hysteroscopic procedure. This is performed using a telescopic device with diameter usually less than an inch, and introducing instruments through this telescopic device under video guidance. A distention fluid typically normal saline or glycine is used depending on whether electrical devices are used, to be able create operating and visual space in the cavity.  Procedure usually takes less than half hour and is a same day procedure.


Hysteroscopic Treatment of Intrauterine Scars (Asherman’s syndrome)

Sometimes past uterine procedures (D&Cs, myomectomies, C-sections, other uterine surgeries, pelvic infections) can cause scar formation inside the uterine cavity. These in turn can result in in infertility, recurrent miscarriages and sometimes complete stoppage of menstruation. These scars can be corrected via a hysteroscopic procedure. This is performed using a telescopic device with diameter usually less than an inch, and introducing instruments through this telescopic device under video guidance. A distention fluid typically normal saline or glycine is used depending on whether electrical devices are used, to be able create operating and visual space in the cavity. Procedure can take an hour or longer depending on the severity of scars, and is a same day procedure. However, if the scars are too extensive, the procedure may have to be done in several settings as there is a limit of amount of fluid we can use to distend your cavity in one setting. If too much fluid is absorbed into your system this can affect your electrolytes in your blood and can cause fluid in your lungs. While this complication is rare, a specialized device monitors the amount of fluid that is absorbed into your system and the procedure is terminated when a limit is reached. For this reason it is important to have hysteroscopic procedures in experienced and competent hands. After the procedure often times a balloon is left in place for about a week or longer and estrogen treatment is given to avoid scar reformation inside the uterine cavity.


Resection of Intrauterine Septum

Intrauterine septum is a congenital anomaly caused by failure of an embryonic tissue to regress. Depending on the length, it can completely divide the uterine cavity in to two spaces or can create a slight separation at the dome. While many women may have normal fertility with smaller septums, uterine septum is commonly associated with recurrent pregnancy losses. Uterine septum can be successfully resected using a hysteroscopic approach. This is performed using a telescopic device with diameter usually less than an inch, and introducing instruments through this telescopic device under video guidance.  A distention fluid typically normal saline or glycine is used depending on whether electrical devices are used, to be able create operating and visual space in the cavity. Procedure can take an hour or less depending on the length of the septum, and is a same day procedure.

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