At the moment, they are conventionally divided into three types. Surgeons resort to the traditional, hysteroscopic, laparoscopic removal method.
The traditional method of removal is the usual cavity operation, in which the uterus is cut and the polyp is removed using standard surgical instruments. But this method is used extremely rarely, since it has long been considered obsolete. Moreover, it is established that it is dangerous, and carries many risks. So, the recovery takes a long time, the risk of bleeding increases. The operation is rather complicated, it takes a very long time. The main difficulty is that you need to consistently cut all the overlying layers, as well as the uterus itself, make the necessary manipulations to remove the polyp, sew all layers.
A safer method is hysteroscopy: it is widely used in practice. This method is considered to be low-traumatic, making the floor a mild anesthesia, which lasts only 15-20 minutes. The essence of the method is that the polyp is removed without producing any incisions. All necessary manipulations are carried out naturally, through the opening of the cervix by special instruments (hysteroscope). When applying this method, the recovery occurs quickly enough, the same day the woman can go home.
One of the subspecies of hysteroscopy is scraping, which is performed under the control of a hysteroscope. But this method is also obsolete, and is practically not used at present, because it is highly traumatic, and often leads to serious disruption of the structure and function of the uterus. The consequence of this method is often infertility.
Another popular modern method is laparoscopic removal, which is performed with a special instrument - a laparoscope. In order to remove the polyp laparoscopically, you need to make a small laparoscopic access.
In fact, several punctures are made on the ventral side in the abdominal region. Through this puncture, a laparoscope is first introduced - a tool that is equipped with a camera at the end. It allows to examine the operated cavity, to develop tactics of operation. Then through another incision, surgical equipment is introduced, through which I remove the polyp. Recovery is very fast, as the surrounding tissues are practically not damaged. There are almost no scars, postoperative pain also does not disturb much.
How is the endometrial polyp removed in the uterus?
There is no one way to remove the polyp of the endometrium. Each of them has its own shortcomings, as well as its advantages. Below is a description of each method, its features are considered, plus the pros and cons.
The most obsolete method, which is used increasingly rarely, is removal with the help of an open cavity operation. This technique does not require specific equipment, therefore it is widely used in medical institutions that do not have enough funding to purchase high-tech equipment that is required for other, more modern methods. Nevertheless, she continues to confidently save health, and even the lives of many patients.
During this operation, a complete cut of the abdominal wall, all muscle layers, the uterus itself is made, after which the polyp is removed. Then all the layers are sewn. Naturally, this method is highly traumatic. During the operation, all layers and tissues are damaged. It takes a long period of time to fully recover. The risk of complications increases many times: prolonged bleeding, damaged tissue. Against the background of violation of the integrity of the shells, an infectious process can develop.
No less dangerous is scraping, in which the uterine cavity is scraped blindly, cutting off the polyps. It is most often used in the case of the formation of multiple polyps. A serious drawback is that this method is often accompanied by relapses. Polyps tend to form again if the leg or part of the tissue remains. And such a probability is very high, since the doctor during the operation may not notice a part of the polyp.
If he remains, active recovery will take place, and after a while he will form again. There is a risk that the damaged cell will undergo malignancy, which will form the basis for the further formation of a cancerous tumor. Today this method is still used, but it is tried to perform under the control of a hysteroscope, which allows to see completely the entire cavity and the walls of the uterus, the image is visualized on the screen. With this method of carrying out the operation, it will be less traumatic.
Less dangerous is the method of laparoscopy. With this method, a cutaneous incision is not done. Skin punctures are produced in the places where the polyp is located. Through them, special equipment is introduced - a laparoscope. First, the cavity is inspected with a small video camera, which is inserted through the tube. This gives the doctor an opportunity to assess the condition of the endometrium, examine the polyp, and evaluate the scale of the operation. Then through the other tube surgical instruments are introduced, which makes it possible to accurately remove the polyp, while controlling the process with a video camera. This method is less painful, strong tissue damage is not observed, so recovery is rapid, complications are rare.
The method of hysteroscopy is considered the safest. The operation is performed through the opening of the cervix using special expanders, using a hysteroscope. At the end of this device is a camera, through which the doctor examines the entire cavity of the uterus and determines the further course of the operation. Noticing the polyp, the doctor removes it with an electric loop, which makes it possible to cut it completely, under the foot. The site of the cut is cauterized with liquid nitrogen, or 5% iodine tincture, which helps prevent relapse, and is a reliable prevention of infection and inflammation.
The operation is painless, fast (takes an average of 15-20 minutes). It can be performed not only under general anesthesia, but also under local anesthesia. The method is chosen by an anesthesiologist, based on many parameters, including the patient's condition, the severity of the disease, the amount of surgical intervention. This procedure is recommended for 2-3 days after the end of menstruation, because it is during this period that the uterine mucosa becomes as thin as possible and the polyp rises above the surface. It is easy at this time to be deleted.
Also in many clinics polyps are removed using a laser. This is the method that allows you to accurately and accurately remove the polyp, without injuring the surrounding tissues. This sparing method, which practically does not damage the uterus, does not leave scarring. Therefore, it can be applied even to nulliparous women who are still planning to have children. The laser makes it possible to remove the polyp layer by layer. The doctor can clearly control the depth at which the laser beam penetrates. Due to the removal by the beam, there is no effect on the possibility of fertilization of the oocyte.
How long does the removal of the endometrial polyp?
The average manipulation takes about 30 minutes.
Removal of glandular polyp of the endometrium
The glandular polyp is a formation that is formed by glandular cells. They tend to sprout if they are not treated. For removal, the method of hysteroscopy is most often used, since such polyps are quickly removed as soon as they are hooked under the foot. In addition, this method makes it possible to clearly visualize the polyp, and to prevent the occurrence of a relapse, removing the polyp completely, including the vessels that feed it.
Hysteroscopy and hysterosectoscopy of the endometrial polyp
They are based on the use of specific equipment and a mini video camera. With the help of these tools, it is possible to discover, investigate the polyp with maximum accuracy and remove it. This operation is simple enough, does not require immediate access, since access to the polyp is carried out naturally - through the cervical canal.
Surgical instruments are inserted through the hysteroscope tube. The polyp under the control of the chamber is removed by means of special scissors and forceps. Removal is carried out accurately and accurately, by separating the leg of the polyp from the wall of the uterus. It is important to completely remove the leg, since if it is not removed completely, the polyp will re-grow.
Also, the method has its advantages, as it makes it possible to visualize existing pathologies by displaying an image on the screen. The image is enhanced by the introduction of a contrast medium.
Another advantage is that the risk of damage is almost non-existent, anesthesia is used short-term. This type of surgery is minimally invasive, so the risk of damage, bleeding, is virtually nonexistent. Due to the absence of abdominal incision, the process of recovery is significantly accelerated. Such an operation does not imply mandatory hospitalization. If everything went smoothly and without complications, the woman is released home the same day. It is important that the uterus does not leave a scar, so the operation does not affect the ability of a woman to bear and give birth to a healthy child.
Due to the absence of peritoneal incisions and a low degree of damage to surrounding tissues, the operation is well tolerated and will also be performed after abortions, childbirth, and other gynecological interventions. Often used to remove the remains of the fetal egg, the placenta.
Resectoscopy of the endometrial polyp
The method has some similarities with the method of hysteroscopy. The difference is that the removal is done using a resectoscope, which is a special loop for removal.
The procedure looks like this: the patient is anesthetized, then antiseptic treatment is performed. Expanders are introduced into the cervical canal. They allow you to expand the channel and enter a hysteroscope. To spread the walls of the uterus, a special liquid is introduced into the cavity. A loop of the resectoscope is inserted through the hysteroscope tube. The hysteroscope allows you to monitor the progress of the operation, since it contains a camera, through which the entire surgical site is visualized.
Scraping endometrial polyp
This is an outdated method, in which the uterine cavity is scraped with a special sharp instrument (curette).
Preparation for curettage of the endometrial polyp . Today, scraping is performed after diagnostic hysteroscopy, which allows the doctor to examine and remember the location and features of the structure of the polyp.
Removal of the endometrial polyp by the laser
The laser is one of the safest methods to remove it as accurately as possible. This is an aiming method, in which the surrounding tissues are not damaged, it is also impossible to get an injury. The advantage is that the laser does not leave scars on the neck, as a result of which the method does not affect the reproductive function of the woman. Accordingly, it can be applied to women who are still planning to have children, which is important in gynecology.
Scars and traces do not remain, the risk of complications, infection, bleeding is excluded. Removal of polyps by laser is considered the most effective and safe way. It allows you to delete a polyp layer by layer.
It is also important that laser removal does not require further hospitalization of the patient. The procedure on average lasts no more than 2-3 hours, after which the woman must stay for some time under the supervision of a doctor, and with a satisfactory state of health, can immediately go home. Recovery is very fast, a woman may not even take a sick leave. Nevertheless, it is necessary to attend routine inspections.
Removal of the endometrial polyp by the radio-wave method of the sargitron
At the heart of the impact is the use of radio wave radiation. High-energy radio waves are used, which have a restoring effect on the body. The procedure is fast enough, painless. Relapses do not occur, because additional thermal treatment of the operated site is applied. In this case, the probability of obtaining an electric burn is virtually eliminated.
For all the years of practice, no such case has been recorded. The method is good because it does not leave scars, does not damage the mucous membrane. Recovery after surgery occurs over a period of 3 weeks to several months. Indications for the exercise are any polyps, if they are benign. After the procedure, mandatory coagulation is carried out. It is worth noting that the procedure is so painless that it is carried out without anesthesia.
Cauterization of the endometrial polyp
Immediately after the operation, the place of removal of the polyp is cauterized, which avoids the re-growth of the polyp, prevents bleeding. In some cases, if the polyps are small enough, they can be burned without removing. For cauterization use liquid nitrogen, or an alcohol solution of iodine.