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Endoscope Investigation

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Endoscope of trachea and oesophagus of a Chihuahua

Further gynaecological investigations

Colposcopy

A colposcope is a low-powered microscope used for examining the v aspect of the cervix. It is attached to a stand which can be adjuste height and angle, with a light for illuminating the field. The patie placed in the lithotomy position and the cervix is exposed with a bi speculum. The colposcope is focused onto the cervix, which is p . with dilute acetic acid which temporarily stains abnormal epitheliumw

Normal squamous epithelium on the vaginal aspect of the cervix I pale, smooth and opaque. Normal columnar epithelium of the ce canal and of the surface of the cervix near to the external os shows fme folds, which when magnified appear as small translucent' processes.

Colposcopy is of great value in detecting areas of dysplasia, carcin in-situ or early invasive carcinoma (see pp. 166-171).

Endometrial biopsy

The most reliable method of examining the endometrium, whethe diagnosis of functional disorders of menstruation, of tuberculosis, carcinoma, is by curettage after dilatation of the cervix under ge anaesthesia.

In cases of infertility, endometrial biopsy in the latter part of the will demonstrate the presence or absence of the luteal phase, and show whether ovulation has taken place in that cycle.

It is possible to obtain tissue for endometrial biopsy by using a suction aspirator (Vabra aspirator) without general anaesthesia, but gynaeco10gists believe that, whenever there is the least suspicion malignant disease, curettage should be performed under general anaes

In cases of suspected tuberculosis not only is premenstrual endome examined histologically, but also fragments are used to set up ba logical cultures.

Hysteroscopy

This procedure is under trial in some centres. Under general anaesth small telescope ~s passed through the cervix. After distending the with fluid or gas a limited view of the uterine cavity can be obt .

Laparoscopy

Inspection of the pelvic organs through an endoscope was formerly c out through the posterior vaginal fornix with the patient in the knee position (culdoscopy). This method has been superseded by the in of an endoscope with a fibre-optic light cable and a small telescope t the anterior abdominal wall (laparoscopy). An excellent view of the organs is obtained. For technique see p. 359.

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