Board Certified
Obstetrics and Gynecology
 
PROCEDURE NOTE
Procedure: Diagnostic Hysteroscopy, endometrial thermoballon Ablation
Pre op Diagnosis: DUB, menorrhagia
Post op Diagnosis: same
Surgeon: Idalia Talavera MD
Ebl: 25 cc
Complications: none

After the patient was given valium 5 mg PO and Toradol 30 mg  IM and under good illumination, with the patient in lithotomy position the vulvar area was cleansed using betadine. A sterile underbutttock plastic bag was placed.  A heating pad was placed on the suprapubic area. A speculum was inserted and the vaginal area was prep with betadine.  Rupivacaine was injected superficially at 12 o’clock cervical position and a tenaculum was placed in that location. Then the anesthetic was injected at 2,4,7 and 10 o’clock positionof the uterovaginal reflection into the myometrium about 1.5 cm. Once that was accomplished, endocervical canal was dilated until a 5 mm hysteroscope could be introduced. A diagnostic hysteroscopy was performed . The only abnormal finding was that the endometrium was slightly thickened. The hysterocope was removed. At that moment I decided to proceed with the ablation. The baloon was tested for integrity using D5W  and then primed. After inserting the balloon in the endometrial cavity the pressure was estabilized at about 160 mmHg. The cycle was started and the ballon was heated to 87 degrees and the ablation was done for 8 min. After cooling down the balloom was removed. The integrity of the ballom was again tested. A second hysteroscopic evaluation was performed. No signs of beeding, perforation or other anomalies. Instruments were removed. Pt tolerated the procedure.

 
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