Office Hysteroscopy. An operative gold standard technique and an important contribution to Patient Safety

Abstract

According to World Health Organization (WHO), about 1 out of 10 hospitalized patients suffers an adverse event, in developed countries, being an adverse event an injury related to medical management, in contrast to complications of disease. These events cause both unnecessary suffering and huge cost to health systems. This issue is so important that WHO has defined it as a global health problem and in 2004 launched the World Alliance for Patient Safety, with the aim to coordinate, disseminate and accelerate improvements in Patient Safety. Office Hysteroscopy (OH), as an independent technique of the hospital circuit, has the ideal conditions to be qualified as the gold standard technique for the surgical treatment of intracavitary uterine pathology. It does not require the use of an operating room, hospital admission and general or locoregional anaesthesia. The appropriate surgical techniques, allied to pain control, allow OH to resolve much more than 90 % of the surgical needs of the intracavitary uterine pathology, thus being an important contribution for Patient Safety.

Is every patient eligible to have an office hysteroscopy? A retrospective analysis of 1301 procedures.

“…Considering only the diagnostic procedures, the percentage of successful office procedures rises to about 91%. These results are comparable to those reported in the literature [1,13]. As it was supposed, diagnostic hysteroscopy seems to be the best tolerated of all hysteroscopic procedures, and less than 10% of patients require general anesthesia for this kind of intervention.…”

“…Hysteroscopy is a gold standard for diagnosing and treatment intrauterine pathologies [1,2]. Over the years, hysteroscopic equipment has changed, and so have the procedure settings.…”

Re: An economic evaluation on outpatient versus inpatient polyp treatment for abnormal bleeding

“…Economic issues are not the only arguments in favour of outpatient treatment; reducing hospitalisation also decreases complications, so ambulatory procedures are in fact safer practices in line with World Health Organization (WHO) recommendations on World Alliance for Patient Safety. 4 A new approach on local 'hysteroscopic' anaesthesia may offer an alternative to pain control and increase women's acceptance. 3 Outpatient hysteroscopy and polypectomy should be preferred to hospitalisation not on economic grounds alone, but because it is safer; for these reasons, outpatient treatment here is in the women's best interests.…”

“…Economic issues are not the only arguments in favour of outpatient treatment; reducing hospitalisation also decreases complications, so ambulatory procedures are in fact safer practices in line with World Health Organization (WHO) recommendations on World Alliance for Patient Safety …”

Operative and diagnostic hysteroscopy: A novel learning model combining new animal models and virtual reality simulation

“…Diagnostic and operative hysteroscopy is one of the most common surgical interventions in gynaecology, allowing for diagnosis and treatment of a wide range of pathologies [1,2]. In recent years, the technological advancements such as the use of small diameter (3,5 mm) rigid hysteroscopes combined with "no touch" techniques have made hysteroscopy a commonly accepted procedure [3,4]. Nevertheless, it is not painless [5,6] and it is not complications-free [7].…”