title: Implementation of hysteroscopic surgery in The Netherlands.
abstract: OBJECTIVE
  This study was conducted to assess the degree of diffusion of hysteroscopic surgery in gynaecological practice in The Netherlands in order to guide further implementation. The diffusion was objectified by defining the percentage of hospitals performing hysteroscopic procedures and the number of different procedures performed per gynaecologist.
  
  
  METHODS
  In 2003 all Departments of Gynaecology (n=102) in The Netherlands were sent a questionnaire. The questionnaire addressed the number and type of all hysteroscopic procedures that were performed in each hospital in 2002. Data from this study were compared to previously published data from 1997.
  
  
  RESULTS
  Responses were received from 80% of all gynaecological departments in The Netherlands. Diagnostic hysteroscopy was performed in almost all hospitals in both 1997 and 2002. The percentage of hospitals that adopted polypectomy, myomectomy and endometrial ablation increased to more than 90% in 2002. The number of teaching hospitals that integrated diagnostic hysteroscopy, polypectomy and myomectomy (procedures required for graduation) into their operative spectrum increased to 100%.
  
  
  CONCLUSIONS
  This survey indicates a growing trend of the diffusion of diagnostic and "basic" therapeutic hysteroscopic procedures in The Netherlands. However, figures upon more advanced hysteroscopic surgery are less optimistic.
authors.affiliation: Leiden University Medical Center, Department of Gynaecology, k6-76, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
authors.forename: Heleen
authors.initials: H
authors.lastname: van Dongen
authors.forename: Wendela
authors.initials: W
authors.lastname: Kolkman
authors.forename: Frank Willem
authors.initials: FW
authors.lastname: Jansen
mesh_terms: D004059:Diffusion of Innovation; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D015907:Hysteroscopy / Q000706:statistics & numerical data*; D009426:Netherlands; D009775:Obstetrics and Gynecology Department, Hospital / Q000639:trends*