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Dear Poly,

My translation of the surgery report will probably help you make

sense of the video:

Helsinki City Maternity Hospital, Surgery Department 7, 29.11.2002

Procedure: LCB98 Hysteroscopia, resectio adhesiones cervicis et

intrauterina.

Performed by Timo Laatikainen, senior surgeon - -Maija Tapper,

head of the clinic of gynaecology - nurse Miettinen - nurse Yli-

Ollila.

When entering the cervical channel, the dilators stop at only 1 cm.

The hysteroscope shows a thick white adhesion across the cervical

channel. This is removed using the versapoint until the cervical

channel is open. At this stage the sound measurement is about 5 cm.

The cavity is filled with thick white adhesions. These are removed

using versapoint until the left tube is seen. At the beginning of

this procedure, some dark fluid and blood flows out of the cavity (cd

10). Adhesions are removed all the way up to the tubes, but the right

tube is still not visible. Finally the cavity looks fairly symmetric,

but cylindrical. On the right side and also in the left corner some

intact endometrium is seen. The ultrasound shows that some saline

solution has flushed through the tubes and into the abdominal cavity.

Plan: The patient is given a prescription for Divina

(estradiolvalerat 2 mg 1 x 1 x 11 days, estradiolvalerat 2 mg +

medroxyprogesteronacetat 10 mg 1 x 1 x 10 days, 7 days pause). The

patient will contact the clinic for a follow-up appointment with Dr.

Laatikainen after three months. On her request, the patient is given

a videotape of the procedure. She will also contact docent Aila

Tiitinen for advice on further hormone treatment.

Dg: N85.8 Syndroma Asherman.

Timo Laatikainen, senior surgeon.

I tried to find a few important elements on the video:

- adhesions (no trouble, since they were all over)

- using the versapoint laser

- tube opening (not sure about this one, can you identify it, maybe?)

- open cavity at the end of the procedure

- healthy endometrium (pink and smooth)

The versapoint vaporises the adhesions, that's why there are lots of

gas bubbles in some pictures.

When the report says right or left I get the impression they are

referring to MY right and left, which means the intact endometrium on

the right side is actually in the left part of the picture.

These are my suggestions, minutes and seconds starting from beginning

of tape:

01:55-02:30 thick white adhesion being vaporised using versapoint

laser

03:45–04:05 same

11:50–12:30 adhesion vaporised using versapoint laser + endometrium

on the left

23:00–23:10 open cavity starting to emerge after cutting lots of

adhesions

26:00–26:15 open cavity, pink endometrium in the upper left part

27:25–27:35 exit from open cavity, end result showing lots of

scarring on the walls but all adhesions removed except in front of

one tube.

These are just suggestions, please feel free to use any clips you

want to. Ask if there is anything you need clarified. I'm afraid I

don't have all the answers, though, because I didn't watch the video

with the doctors afterwards.

It was very interesting (but depressing) for me to see this on video,

so I think it could be interesting for others also, to get a live

picture of what this much talked about scar tissue looks like, for

instance. Good luck with the editing!

F

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Dear Poly,

My translation of the surgery report will probably help you make

sense of the video:

Helsinki City Maternity Hospital, Surgery Department 7, 29.11.2002

Procedure: LCB98 Hysteroscopia, resectio adhesiones cervicis et

intrauterina.

Performed by Timo Laatikainen, senior surgeon - -Maija Tapper,

head of the clinic of gynaecology - nurse Miettinen - nurse Yli-

Ollila.

When entering the cervical channel, the dilators stop at only 1 cm.

The hysteroscope shows a thick white adhesion across the cervical

channel. This is removed using the versapoint until the cervical

channel is open. At this stage the sound measurement is about 5 cm.

The cavity is filled with thick white adhesions. These are removed

using versapoint until the left tube is seen. At the beginning of

this procedure, some dark fluid and blood flows out of the cavity (cd

10). Adhesions are removed all the way up to the tubes, but the right

tube is still not visible. Finally the cavity looks fairly symmetric,

but cylindrical. On the right side and also in the left corner some

intact endometrium is seen. The ultrasound shows that some saline

solution has flushed through the tubes and into the abdominal cavity.

Plan: The patient is given a prescription for Divina

(estradiolvalerat 2 mg 1 x 1 x 11 days, estradiolvalerat 2 mg +

medroxyprogesteronacetat 10 mg 1 x 1 x 10 days, 7 days pause). The

patient will contact the clinic for a follow-up appointment with Dr.

Laatikainen after three months. On her request, the patient is given

a videotape of the procedure. She will also contact docent Aila

Tiitinen for advice on further hormone treatment.

Dg: N85.8 Syndroma Asherman.

Timo Laatikainen, senior surgeon.

I tried to find a few important elements on the video:

- adhesions (no trouble, since they were all over)

- using the versapoint laser

- tube opening (not sure about this one, can you identify it, maybe?)

- open cavity at the end of the procedure

- healthy endometrium (pink and smooth)

The versapoint vaporises the adhesions, that's why there are lots of

gas bubbles in some pictures.

When the report says right or left I get the impression they are

referring to MY right and left, which means the intact endometrium on

the right side is actually in the left part of the picture.

These are my suggestions, minutes and seconds starting from beginning

of tape:

01:55-02:30 thick white adhesion being vaporised using versapoint

laser

03:45–04:05 same

11:50–12:30 adhesion vaporised using versapoint laser + endometrium

on the left

23:00–23:10 open cavity starting to emerge after cutting lots of

adhesions

26:00–26:15 open cavity, pink endometrium in the upper left part

27:25–27:35 exit from open cavity, end result showing lots of

scarring on the walls but all adhesions removed except in front of

one tube.

These are just suggestions, please feel free to use any clips you

want to. Ask if there is anything you need clarified. I'm afraid I

don't have all the answers, though, because I didn't watch the video

with the doctors afterwards.

It was very interesting (but depressing) for me to see this on video,

so I think it could be interesting for others also, to get a live

picture of what this much talked about scar tissue looks like, for

instance. Good luck with the editing!

F

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Dear Poly,

My translation of the surgery report will probably help you make

sense of the video:

Helsinki City Maternity Hospital, Surgery Department 7, 29.11.2002

Procedure: LCB98 Hysteroscopia, resectio adhesiones cervicis et

intrauterina.

Performed by Timo Laatikainen, senior surgeon - -Maija Tapper,

head of the clinic of gynaecology - nurse Miettinen - nurse Yli-

Ollila.

When entering the cervical channel, the dilators stop at only 1 cm.

The hysteroscope shows a thick white adhesion across the cervical

channel. This is removed using the versapoint until the cervical

channel is open. At this stage the sound measurement is about 5 cm.

The cavity is filled with thick white adhesions. These are removed

using versapoint until the left tube is seen. At the beginning of

this procedure, some dark fluid and blood flows out of the cavity (cd

10). Adhesions are removed all the way up to the tubes, but the right

tube is still not visible. Finally the cavity looks fairly symmetric,

but cylindrical. On the right side and also in the left corner some

intact endometrium is seen. The ultrasound shows that some saline

solution has flushed through the tubes and into the abdominal cavity.

Plan: The patient is given a prescription for Divina

(estradiolvalerat 2 mg 1 x 1 x 11 days, estradiolvalerat 2 mg +

medroxyprogesteronacetat 10 mg 1 x 1 x 10 days, 7 days pause). The

patient will contact the clinic for a follow-up appointment with Dr.

Laatikainen after three months. On her request, the patient is given

a videotape of the procedure. She will also contact docent Aila

Tiitinen for advice on further hormone treatment.

Dg: N85.8 Syndroma Asherman.

Timo Laatikainen, senior surgeon.

I tried to find a few important elements on the video:

- adhesions (no trouble, since they were all over)

- using the versapoint laser

- tube opening (not sure about this one, can you identify it, maybe?)

- open cavity at the end of the procedure

- healthy endometrium (pink and smooth)

The versapoint vaporises the adhesions, that's why there are lots of

gas bubbles in some pictures.

When the report says right or left I get the impression they are

referring to MY right and left, which means the intact endometrium on

the right side is actually in the left part of the picture.

These are my suggestions, minutes and seconds starting from beginning

of tape:

01:55-02:30 thick white adhesion being vaporised using versapoint

laser

03:45–04:05 same

11:50–12:30 adhesion vaporised using versapoint laser + endometrium

on the left

23:00–23:10 open cavity starting to emerge after cutting lots of

adhesions

26:00–26:15 open cavity, pink endometrium in the upper left part

27:25–27:35 exit from open cavity, end result showing lots of

scarring on the walls but all adhesions removed except in front of

one tube.

These are just suggestions, please feel free to use any clips you

want to. Ask if there is anything you need clarified. I'm afraid I

don't have all the answers, though, because I didn't watch the video

with the doctors afterwards.

It was very interesting (but depressing) for me to see this on video,

so I think it could be interesting for others also, to get a live

picture of what this much talked about scar tissue looks like, for

instance. Good luck with the editing!

F

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F,

I read your e-mail with great interest as I too have a video of my

hysteroscopy. I was very interested about the walls looking pink and smooth

where there was healthy endometrium - should the uterus look completely pink

along the walls? I ask this because my gynae was very pleased with his work

but, although the cavity had been beautifully opened up, I certainly didn't

have pink walls - only a mixture of white and pink. I am currently quite

worried as I have been told all is fine and I should ttc even though my

periods are still light and I know from a recent scan there is some

scarring along the walls, even though I thought this was minimal. I would be

really happy if you could tell me whether the uterine walls should be pink

all over - not mainly white with patches of pink.

Thanks so much,

a

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F,

I read your e-mail with great interest as I too have a video of my

hysteroscopy. I was very interested about the walls looking pink and smooth

where there was healthy endometrium - should the uterus look completely pink

along the walls? I ask this because my gynae was very pleased with his work

but, although the cavity had been beautifully opened up, I certainly didn't

have pink walls - only a mixture of white and pink. I am currently quite

worried as I have been told all is fine and I should ttc even though my

periods are still light and I know from a recent scan there is some

scarring along the walls, even though I thought this was minimal. I would be

really happy if you could tell me whether the uterine walls should be pink

all over - not mainly white with patches of pink.

Thanks so much,

a

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Dear Ivana,

thank you for giving me hope, I really appreciate that and need it

badly because I was afraid Dr Gallinat will tell me there is nothing

he can do for me. Of course he hasn't said anything yet, because he

will get the video next week (I'm sending it with Nina who is going

there for surgery).

F

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Dear Ivana,

thank you for giving me hope, I really appreciate that and need it

badly because I was afraid Dr Gallinat will tell me there is nothing

he can do for me. Of course he hasn't said anything yet, because he

will get the video next week (I'm sending it with Nina who is going

there for surgery).

F

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Dear Ivana,

thank you for giving me hope, I really appreciate that and need it

badly because I was afraid Dr Gallinat will tell me there is nothing

he can do for me. Of course he hasn't said anything yet, because he

will get the video next week (I'm sending it with Nina who is going

there for surgery).

F

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F,

Thanks for your email. I have kept a copy for when my nephew comes over in about a weeks time. I will ask any questions after we have viewed it together. I didn't get a chance to see all of it but did see a little and I think it will be good to get this available on the internet for educational purposes.

Thanks again.

Poly

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