Hysteroscopic surgical instruments are divided into three forms: hard, soft, and semi hard. Soft and semi hard instruments have a diameter of 6-9Fr (2-3mm) and can undergo intrauterine surgery through the hysteroscopic sheath. These instruments include forceps, biopsy forceps, scissors, and electrodes. Hard instruments cannot pass through the hysteroscopic sheath, but it is necessary to connect the operating sheath. Therefore, it is necessary for the connected endoscope and surgical sheath to pass through the cervix as a whole. Few doctors are accustomed to using rigid instruments.
Generally speaking, small and soft instruments are prone to breakage, making them suitable for minor surgeries. These instruments have the advantage of being able to achieve wide-angle positioning by moving the sheath. These operations are rarely used in practical work. If the diameter of the hysteroscope sheath can reach 3mm, larger, semi rigid instruments are often the preferred choice. The 2mm instrument meets the appropriate standard operating sheath (Figure 12.3A, B).
They are suitable for performing fine surgeries at the end of close-up shots or sliding off the endoscope for panoramic operations. Basically, the orientation of surgical instruments is relatively independent of the orientation of the light source
Compared to semi-rigid instruments, 3mm instruments are manufactured for large-scale equipment. The soft design of large instruments can avoid twists and turns and breakage. The large hook shaped scissors are suitable for quickly cutting open the septum, especially for wider septectomy. Small scissors are actually only used to cut through thin septa and separate thin adhesions.
Although individual hysteroscopic instruments can be replaced by 2mm or 3mm forceps, early instruments were completely unsuitable for embedded devices. Only large biopsy forceps can provide satisfactory specimens for pathologists to conduct pathological examinations. The small biopsy forceps are too small to provide satisfactory specimens for pathological examination. If 32% D-glucose-70 (Hyskon) is used as dilation fluid, it is necessary to immediately rinse all instruments with hot water after use. If the Hyskon on the head of these instruments dries and the handle is forced to open, the instruments may break. Hysteroscopic instruments need to undergo high-pressure steam sterilization. Hard instruments are classified as large instruments
They have always been integrated with a special protective sheath. Endoscopy actually involves passing through the inner sheath of a rigid instrument to reach the uterine cavity
Therefore, the light source system only provides a limited field of view and is limited by surgical instruments within a certain atmosphere
In fact, this scale is very close to the bottom of the light source, providing the operator with a close-up lens on a small scale. These instruments can remove large lesions, more precisely, they can withstand the greater pulling force when removing lesions. It is worth noting that these instruments need to pass through the cervix as a whole with the operating sheath, while extending the operating sheath, which increases the wound and difficulty when passing through the cervix. Also, when entering the cervix, the condition of the cervix cannot be seen.