Operative hysteroscopy in the office setting

Efficiency and pregnancy outcome of serial intrauterine device–guided hysteroscopic adhesiolysis of intrauterine synechiae

“…Use of the Versapoint hysteroscopic electrosurgical electrode with bipolar coagulation (Ethicon, Somerville, NJ) may be performed as an outpatient procedure (22,29). Neither electrosurgery nor the neodymium-doped yttrium-aluminium-garnet laser offers any advantage over scissors for dissection of IUAs (9,30).…”

Resectoscopic versus bipolar electrode excision of endometrial polyps: a randomized study

“…This generally does not allow to "see and treat" polyps in an outpatient setting (16,17). Another disadvantage of the resectoscope is that the instruments are different from those traditionally used for diagnostic hysteroscopy.…”

Hysteroscopic Myomectomy

“…An additional benefi t of offi ce-based operative hysteroscopy has been suggested by Lindheim et al [ 2 ], who more than a decade ago, noted the cost saving per case of at least 50 % when compared with the hospital equivalent. The approach with vaginoscopy or "no touch" technique, without using speculum, tenaculum or even anesthesia is another well tolerated advantage of offi ce hysteroscopy and patients reported just little discomfort [ 3 ].…”

“…On the other hand, with hysteroscopic morcellation, the amount of tissue removed per minute will only be a function of [ 1 ] how much contact the cutting window maintains with the myoma and [ 2 ] how quickly the device can cut tissue and aspirate it out. Because the devices' cutting speeds are relatively fi xed by their design characteristics, minimizing procedure time mostly depends on maintaining tissue contact between the cutting window and the pathology.…”

“…So, uterine cavity distention and illumination was also improved by irrigation with continuous fl ow (Heineberg 1914;Seymour 1926) and application of CO 2 (Rubin 1925) and liquid media (Creevy and Webb 1947; Edstrom and Fernstrom 1970).…”