Common Sense Approach to Gynecology: Using a handheld portable hysteroscopy system to accelerate patient care
CANSAGE ePoster Library. Zhu C. 09/27/19; 275261; eP-128
Cici Zhu
Cici Zhu
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Abstract
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Objective: Concurrent consultation and uterine cavity assessment for gynecologic conditions facilitates both timely diagnosis and treatment plan initiation, which is beneficial for patients, providers, and our health care system. The study objective was to determine if a novel handheld portable hysteroscopy system used at initial gynecological consultation would change patient care to facilitate earlier diagnosis while also avoiding additional evaluation and procedures. Methods: This is a non-interventional test-retest cohort study. Participants are Staff and Fellow gynecologists in a tertiary-level center. Pre- and post-procedure questionnaires were administered to physicians to delineate their provisional versus post-procedure diagnoses and to clarify management changes. All providers were trained to utilize the Endosee hysteroscopy system (Cooper Surgical Inc.). Results: 5 physicians participated in this study for a total of 15 completed cases. Providers rated their technical performance of the procedure as “comfortable” or “very comfortable” in 14(93%) of cases.Patients were seen for possible uterine polyp(n=6), submucosal fibroid(n=2), abnormal uterine bleeding(n=3), mal-positioned IUD(n=1), cesarean-scar defect(n=1), recurrent miscarriage(n=1), and endometrial hyperplasia(n=1). After in-office hysteroscopy, 12(80%) patients had a change in diagnosis and treatment plan, 10(67%) required no further evaluation, and 3(20%) did not need the surgery for which they were consulted due to absence of pathology. Conclusion: Addition of a handheld portable hysteroscopy system at time of gynecologic consultation may improve patient care by providing an immediate diagnosis and plan while avoiding further imaging, office visits, and unnecessary procedures. This may then lead to increased health care efficiency and reduced costs.
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