Hysteroscopy is not in itself a new technique; visualization of the uterine cavity was first described by Pantaleoni as long ago as 1869.<sup>54 Pantaleoni D.C. On endoscopic examination of the cavity of the womb The Medical Press and Circular 1869 ;  8 : 26-27

Cliccare qui per andare alla sezione Riferimenti</sup> In recent years, however, the use of hysteroscopy, both as a diagnostic and in particular as a therapeutic tool, has taken off as surgical equipment has improved along with a general drive toward minimally invasive techniques in all the surgical specialties. In this respect, diagnostic hysteroscopy, which generally can be performed as an outpatient procedure without the need for general anesthesia, is replacing dilatation and curettage in the diagnosis of abnormal uterine bleeding.<sup>24 Goldrath M.H., Sherman A.I. Office hysteroscopy and suction curettage: Can we eliminate the hospital diagnostic dilatation and curettage? Am J Obstet Gynecol 1985 ;  152 : 220-229

Cliccare qui per andare alla sezione Riferimenti</sup> Other diagnostic indications include investigation of recurrent miscarriage, primary or secondary infertility, and location and retrieval of fractured or embedded intrauterine contraceptive devices. The hysteroscopic technique of therapeutic endometrial ablation now offers a minimally invasive alternative to hysterectomy in the surgical management of menorrhagia,<sup>35 Ke R.W. Endometrial ablation: An alternative to hysterectomy Clin Obstet Gynecol 1997 ;  40 : 914-927  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> with reduced hospital stay and early recovery period<sup>55 Pinion S.B., Parkin D.E., Abramovich D.R. , e al. Randomised trial of hysterectomy, endometrial laser ablation, and transcervical endometrial resection for dysfunctional uterine bleeding Br Med J 1994 ;  309 : 979-983

Cliccare qui per andare alla sezione Riferimenti</sup> and lower postoperative morbidity<sup>20 Dwyer N., Hutton J., Stirrat G.M. Randomised controlled trial comparing endometrial resection with abdominal hysterectomy for the surgical treatment of menorrhagia Br J Obstet Gynaecol 1993 ;  100 : 237-243  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> compared with the abdominal procedure. In selected patients, symptomatic submucous fibroids can be resected hysteroscopically, again avoiding the need for an intraabdominal procedure.<sup>52 Neuwirth R.S. Hysteroscopic management of symptomatic submucous fibroids Obstet Gynecol 1983 ;  62 : 509-511

Cliccare qui per andare alla sezione Riferimenti</sup> Hysteroscopic techniques can also be used in the treatment of the septate uterus and lysis of uterine adhesions.<sup>60 Siegler A.M., Valle R.F. Therapeutic hysteroscopic procedures Fertil Steril 1988 ;  50 : 685-701

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As with other minimally invasive surgical techniques, improvements in equipment, greater experience, and familiarity with techniques have ensured that complication rates remain extremely low. Nevertheless, the infrequent but potentially disastrous nature of these complications makes it imperative for all those involved with the surgery to remain vigilant. In the provision of anesthesia for these techniques, therefore, the anesthesiologist must be aware of the potential hazards associated with the procedures and is often best placed for their early detection and prompt treatment.