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Major advancements in gynaecological tech will reduce waiting lists for women

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Chris Lindley, consultant obstetrician and gynaecologist, Hampshire Hospitals NHS Trust, shares his insights with Health Tech World…

With the NHS under immense pressure, anything that we can do to make our procedures more efficient and effective has obvious upsides for clinicians as well as for our patients.

One area in which significant improvement is being made is in gynaecological procedures.

This will allow us to do many more outpatient procedures and to do them more quickly, providing huge benefits to the thousands of women we treat each year, particularly those on long waiting lists.

Advances in technology

Advances in technology mean that we now have better tools to view the cervix, cervical canal and the inside of the uterus.

Many doctors have become highly skilled in the use of a hysteroscope, which allows digital images to be captured and viewed on a large monitor.

If an abnormal condition is detected during the diagnostic hysteroscopy, an operative hysteroscopy can sometimes be performed at the same time, avoiding the need for a second visit.

The advantage of this is that it can provide shorter hospital stays, a shorter recovery time, faster diagnosis and results, and potential avoidance of general analgesia.

Long-standing issue with a hysteroscopy

However, one long-standing issue has been that diagnostic and operative hysteroscopy requires a lot of fluid to not only distend the uterine cavity for viewing, but also to irrigate the uterine cavity to remove blood and tissue debris during pathology removal procedures.

Absorption of large volumes of liquid can lead to complications arising from fluid overload.

The nursing team has a tough job in ensuring correct fluid distention and accurate monitoring of fluid absorption. While this can be difficult to deal with, a new type of fluid management system now available in the UK, the Hologic Fluent Fluid Management System, has seen a big improvement on current practice within our team.

It allows the measuring and monitoring of fluid in the uterine cavity to be automated in a far simpler and more efficient way. My initial impression of using the new system is that our staff have found it easier to operate than previous fluid management systems: it provides a better view of the uterus and offers a faster procedure with fewer incomplete operations. 

Improving patient experience

All of this leads to significant cost and time savings, whilst improving the patient experience.

Nurses have also found that they can learn to use it more quickly than previous systems, and it’s also quicker to assemble, prepare and clean up afterwards, all of which leads to a faster turnaround time between patients.

These advances in hysteroscopy are likely to help hospitals move towards streamlining the care pathway and potentially providing diagnosis and treatment in one relatively short visit, getting patients seen more quickly and sent home faster than they would have been in the past.

Consequently, we’ll be able to increase capacity within our current clinic slots to treat more patients in the same amount of time to support waiting list reductions.

There will also be fewer appointments required for second procedures, reducing DNAs (did not attends), and a decrease in operating theatre utilisation by avoiding the need for general anaesthesia.

This will enable patients to recover more quickly and to be able to get on with their lives.

So, as well as reducing the pressure on health resources and medical staff, we can look forward to achieving greater patient satisfaction following procedures that for many can be a stressful and invasive experience.

Chris Lindley – 2022

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