Outpatient hysteroscopy was demonstrated to be safe, effective and acceptable to women. Provision of an outpatient hysteroscopy service saves theatre time and approximately $1000 per case. Improved techniques and technology will allow progression to a 'see and treat' service, providing further savings. With budget constraints, increasing wait times for major procedures and concerns about trainee surgical experience, an outpatient hysteroscopy service should be considered the 'gold standard' investigation over hysteroscopy in theatre.

No abstract

The use of NBI at laparoscopy for the investigation of pelvic pain is beneficial in finding additional areas of endometriosis if endometriosis is already suspected after white-light survey in a tertiary laparoscopic unit. Further research in nonspecialized units may show additional benefit and requires further research. NBI may also be useful as a diagnostic aid for trainees.

The objective of this pilot study was to evaluate the extent to which laparoscopic gynaecological surgery could be completed as planned in overweight and obese patients versus patients of normal weight. A prospective surgical audit was conducted of 64 women undergoing laparoscopy for benign gynaecological conditions. Patients were grouped according to their body mass index (BMI). The number of attempts required for successful laparoscopic entry, the ability to identify key surgical landmarks, the ability to complete the planned surgery, the rate of conversion to laparotomy and the complication rates were recorded. Surgery was completed as planned in 95.31% of participants. Completion rates declined with increasing BMI. Increased entry attempts and an inability to identify key surgical landmarks were associated with increased BMI, although the sample size was insufficient to provide any statistically significant conclusions. The overall complication rate was 6.25%. There was a higher mean BMI in patients with a complication; however, there was insufficient data to show a significant difference. This study suggests an association between increasing BMI and increased entry attempts for laparoscopy, increased difficulty in surgical landmark identification and an overall reduction in completion of gynaecological laparoscopy as planned.