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To determine the safety and satisfaction among patients undergoing operative hysteroscopy in an office-based setting. Retrospective analysis (Canadian Task Force classification II-2). Physician's private office. Women undergoing operative hysteroscopy in an office setting. Three hundred eighty-seven women underwent a total of 414 operative hysteroscopic procedures, with use of parenterally administered moderate sedation, a 9-mm operative resectoscope, and sonographic guidance. All patients were American Society of Anesthesiologists class I-III. A total of 305 primary operative hysteroscopic procedures were performed including endomyometrial resection, myomectomy, polypectomy, removal of a uterine septum, and adhesiolysis. One hundred nine (26.3%) repeat operative procedures were performed in women in whom previous endometrial ablation and resection had failed. The average procedure required a mean (SD) of 37.6 (13.5) minutes to complete, and produced 14.1 (10.2) g of tissue. Ninety-nine percent of all procedures were completed. Only 1 patient required a hospital transfer for evaluation of a uterine perforation necessitating diagnostic laparoscopy. There were 8 (1.9%) postoperative infections, and no complications attributable to use of conscious sedation. Two hundred fifty-five women (65.6%) responded to our telephone survey. Two hundred fifty-two (98.8%) respondents were either "very satisfied" or "satisfied." Two hundred forty-nine women (97.6%) preferred the office to a hospital setting, whereas 6 (2.4%) would have preferred a hospital setting. All but 5 respondents would recommend this procedure to a friend. Major operative hysteroscopic surgery can be performed in an office-based setting with a high degree of safety and patient satisfaction. Published by Elsevier Inc.


Morris Wortman, Amy Daggett, Courtney Ball. Operative hysteroscopy in an office-based surgical setting: review of patient safety and satisfaction in 414 cases. Journal of minimally invasive gynecology. 2013 Jan-Feb;20(1):56-63

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PMID: 23107759

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