title: Operative hysteroscopy in an office-based surgical setting: review of patient safety and satisfaction in 414 cases.
abstract: OBJECTIVE
  To determine the safety and satisfaction among patients undergoing operative hysteroscopy in an office-based setting.
  
  
  METHODS
  Retrospective analysis (Canadian Task Force classification II-2).
  
  
  METHODS
  Physician's private office.
  
  
  METHODS
  Women undergoing operative hysteroscopy in an office setting.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Major operative hysteroscopic surgery can be performed in an office-based setting with a high degree of safety and patient satisfaction.
authors.affiliation: Center for Menstrual Disorders and Reproductive Choice, University of Rochester Medical Center, Rochester, New York 14618, USA. moe2020@cmdrc.com
authors.forename: Morris
authors.initials: M
authors.lastname: Wortman
authors.forename: Amy
authors.initials: A
authors.lastname: Daggett
authors.forename: Courtney
authors.initials: C
authors.lastname: Ball
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000191:economics / Q000592:standards*; D000777:Anesthetics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000191:economics / Q000379:methods*; D008875:Middle Aged; D061214:Patient Safety; D017060:Patient Satisfaction; D011183:Postoperative Complications; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014591:Uterine Diseases / Q000601:surgery*
chemical_list: D000777:Anesthetics