This experiment was carried out to investigate the effect of combined treatment of tubal obstruction infertility with deacetylated chitosan and two microscopes on the levels of IFN-γ and ICAM-1. In this study, 100 infertile patients with fallopian tube obstruction who were treated in Jiangbei District Hospital of traditional Chinese medicine from January to August 2019 were divided into two groups according to the alternating grouping method, group A (50 cases) received combined surgery, and Group B (50 cases) received combined surgery and chitosan. The curative effect and postoperative pelvic adhesion of the two groups were analyzed, and the levels of IFN-γ, ICAM-1 and IL6(IL-6), laminin (LN), Transforming growth factor beta 1(TGF-β1) and fibronectin (FN) were observed before and after treatment. Results showed that the total effective rate of Group B was higher than that of Group A (92. 00% vs 76. 00%). The incidence of pelvic adhesion was lower in Group A (4. 00% vs 16. 00%) (P < 0.05). The levels of IFN-γ, ICAM-1, IL-6, LN, FN and TGF-β1 in Group B were significantly lower than those in group A (P < 0.05). In conclusion, the treatment of tubal obstruction infertility with combined deacetylated chitosan and biendoscopy is effective, which can reduce the levels of IFN-γ and ICAM-1, improve the expression of adhesion-related factors and reduce the occurrence of pelvic adhesion.

暂无摘要。

To introduce an effective method combining various endoscopes in the treatment of intravesical migrated intrauterine device (IUD).
A step-by-step explanation of the surgery using video, approved by the Shengjing Hospital of China Medical University.
Shengjing Hospital of China Medical University.
A 39-year-old young woman, in whom an IUD was inserted 2 months prior, presented with frequent urination after IUD insertion. Cystoscope and pelvic computed tomography were performed, and the results showed an IUD in the bladder. The migrated IUD was found partly in the uterus and partly in the bladder by hysteroscope and cystoscope. Management of the migrated IUD consists of 4 steps: (1) lysing the adhesion between the bladder and uterus, (2) suturing the bladder and taking the IUD part out of the bladder, (3) removing the IUD part in the uterus, and (4) suturing the bladder again to reinforce it and suturing the uterus.
The migrated IUD in the bladder was successfully and completely extracted by the method combining various endoscopes; operative time was 56 minutes. In the follow-up period the patient did not report any symptoms of frequency urination. This surgical process has the following characteristics: Preoperative examination should be performed to clarify the ectopic site of the IUD, various endoscopes should be combined for diagnosis and treatment, and endoscopic surgery is an effective treatment method for migrated IUD.

To educate surgeons on the advantages of robotic techniques in hysteroscopic-assisted single-site resection of cesarean scar defect.
A step-by-step video presentation detailing the complete surgical procedure.
University Hospital, Baylor College of Medicine, Houston, Texas.
The first patient was a 34-year-old G2P2002 who complained of dysmenorrhea and menorrhagia, with an expressed desire for a single-site cesarean scar defect correction. Her surgical history included 2 cesarean deliveries, in 2012 and 2014. The second patient was a 34-year-old G4P3013 who complained of dysmenorrhea and a persistent mucus vaginal discharge, with an expressed desire for a cesarean scar defect correction in anticipation of conception. Her surgical history was notable for 3 previous cesarean deliveries. Neither patient\'s ultrasound report showed adenomyosis or any other pathologies.
In both patients, hysteroscopic-assisted robotic single-site resection of the cesarean scar defect was performed, using a monopolar hook, wristed needle drivers, cold scissors, and a diagnostic vs operative hysteroscope. Entry was made through the umbilicus with a 15-mm incision and carried down through the subcutaneous tissue until the fascia was grasped and entered using Mayo scissors. The abdomen was inspected. The bladder was carefully disected off of the lower uterine segment and then backfilled to aid identification of the correct plane for dissection. Once the bladder was adequatetly dissected off of the uterus, the suspected defect could be identified. The monopolar hook was used to incise the defect, and the tip of the hysteroscope was placed through the defect to fully delineate it. The edges were trimed with cold scissors (Endoshears) in the first surgery and the monopolar hook in the second surgery. The uterine defect was closed with 2 layers of countinuous running V-Loc suture. The peritonium was closed with an additional V-Loc suture in a running fashion. Finally, hysteroscopy was performed. The closure was noted to be watertight, verifying successful repair of the defect. In the second case, an intercede was placed over the defect to help prevent future adhesive disease. In addition, after consulting with experts in cesarean scar repair, an energy device was recommended, and thus the monopolar hook over cold scissors was used for the second case due to its superior cutting effect. In both cases, the pelvis was inspected, and hemostasis was observed throughout.
The 2 cases had similar outcomes, with successful repair of the cesarean scar defect and resolution of the patient\'s symptoms. The thickness of the residual myometrium in cesarean scar defect was 2.8 mm in the first case and 2.3 mm in the second case. This video is exempt from Institutional Review Board review. In the first case, the surgery was completed in 90 minutes with only 15 mL of blood loss. The patient was discharged home on the day of surgery and denied any postoperative complications at her follow-up appointment. In the second case, the surgery was completed in 85 minutes with only 10 mL of blood loss. The patient was discharged home on the day of surgery. At her follow-up appointment, she had a positive pregnacy test and denied any postoperative complications. When contacted at a later date, she revealed that she was 15 weeks pregant.
Hysteroscopic-assisted single site resection of a cesarean scar defect is a feasible method for the resection of cesarean scar defect. Use of the robot makes the difficult surgical techniques required for this operation easier and more accessible.

OBJECTIVE: The purpose of this article is to review the published literature and perform a systematic review to evaluate the effectiveness and feasibility of the use of a hysteroscope for vaginoscopy or hysteroscopy in diagnosing and establishing therapeutic management of adolescent patients with gynecologic problems.
METHODS: A systematic review.
METHODS: PubMed, Web of science, and Scopus searches were performed for the period up to September 2013 to identify all the eligible studies. Additional relevant articles were identified using citations within these publications.
METHODS: Female adolescents aged 10 to 18 years.
RESULTS: A total of 19 studies were included in the systematic review. We identified 19 case reports that described the application of a hysteroscope as treatment modality for some gynecologic conditions or diseases in adolescents. No original study was found matching the age of this specific population.
CONCLUSIONS: A hysteroscope is a useful substitute for vaginoscopy or hysteroscopy for the exploration of the immature genital tract and may help in the diagnosis and treatment of gynecologic disorders in adolescent patients with an intact hymen, limited vaginal access, or a narrow vagina.

OBJECTIVE: To compare the use of vaginoscopic vs traditional hysteroscopy in evaluation of the endometrial cavity.
METHODS: Prospective, randomized, single blinded, clinical trial (Canadian Task Force classification I).
METHODS: University-affiliated hospital in Hong Kong.
METHODS: Ninety women scheduled to undergo diagnostic hysteroscopy without anesthesia.
METHODS: Women were randomized to undergo either vaginoscopic hysteroscopy using the H Pipelle for endometrial sampling (n = 45) or traditional hysteroscopy using the standard Pipelle (n = 45). Both procedures were performed without anesthesia and using a rigid 4.5-mm hysteroscope. Main outcome measures analyzed were pain scores using a 10-point visual analog scale during hysteroscopy, endometrial biopsy, and overall pain score of the procedure, success and duration of each procedure, and adequacy of the endometrial sample obtained.
RESULTS: The success rates for vaginoscopic and traditional hysteroscopy were 93.33% and 100%, respectively (p = .24). There was no significant difference in the mean pain score and procedure duration between the 2 hysteroscopic approaches. Endometrial sampling using the H Pipelle was significantly quicker by about 45 seconds compared with use of the standard Pipelle (mean [SD] duration, 1.46 [0.72] min vs 2.20 [1.19] min, respectively; p = .001), with similar biopsy adequacy. Most women (95.5% in both approaches) found the procedure acceptable. There were no intraoperative or postoperative complications.
CONCLUSIONS: Vaginoscopic and traditional hysteroscopic approaches are similar in safety, feasibility, and associated pain. Although the time needed to obtain an endometrial sample using the H Pipelle was quicker than with the standard Pipelle, there is no difference in overall procedure duration.

OBJECTIVE: To investigate the clinical value of ultrasonography via vaginal in diagnosing uterine anomalies.
METHODS: Patients in Infertility Clinic were scanned by endovaginal sonography. Hysterosalpingography (HSG) or hysteroscopy were performed in patients with uterine anomalies confirmed by ultrasonography.
RESULTS: Twenty patients had uterine anomalies. Of them, 10 had double uterus, 4 had bicornuate uterus, 3 arcuate uterus, 2 septate uterus, and the other 1 unicornuate uterus.
CONCLUSIONS: Uterine anomalies are easily detected by endovaginal sonography. The diagnosis of uterine anomalies is important in the treatment of infertility and in the prevalence of complications related to uterine anomalies such as abortion and premature labor in pregnancy.