• Place the patient in the lithotomy position. Both the hip and knee joints could be flexed to 90⁰ and the thighs spread 45⁰ apart. The inner thighs, supra pubic area, vulva, vagina and cervix should cleaned with anti septic.
• The bladder should be emptied and examination under anaesthesia done to confirm the size and shape of the body of the uterus.
• The cervix should be inspected and held at 3 and 9 o'clock with volsellum forceps
• The uterine cavity should be sounded for length before dilating the cervix to an adequate size to pass the hysteroscope without the need to apply any force. However it should not be over dilated to prevent irreversible damage or leakage of the fluid necessary to distend the uterine cavity during the procedure. Sound the cavity again to exclude any perforation following cervical dilatation.
• The assembled hysteroscope or resectoscope should be passed into the cervical canal after ridding the system of any air bubbles under direct vision. The cervical canal opening should be kept at 6 o'clock to cater for the tilt and angle at the tip of the scope.
• The uterus should be inspected systematically starting with the fundus, both tubal ostia, anterior, posterior and lateral walls

 Please click to see Removing endometrial polyps