Where Physicians Should be Performing Essure™

OBG Management says Essure™ (hysteroscopic sterilization) should be performed in an office, not a surgery center:

Where should I be doing Essure?

The optimal place to perform hysteroscopic sterilization is in the office setting. Advantages of the office setting include: patient comfort and familiarity with the environment, efficient use of physicians’ time, cost savings, and favorable reimbursement. Studies have confirmed that insert placement rates are not affected by the location where the procedure is performed, with similar placement rates in the OR, ambulatory surgery center, and the office. Physicians who currently perform these procedures in the OR are often concerned about the process of transitioning these procedures to the office; a common concern is pain management in the office setting. To gain confidence in their ability to perform these cases in the office, physicians can begin by conducting these cases in the OR, using just minimal or no sedation (ie, trying to mimic the office setting). As the physician gains confidence, the transition to the office will be much easier.

What other advantages are there to bringing hysteroscopy into my office?

Retained/impacted IUDs and small endometrial polyps can be removed in the office using the same equipment as for in-office hysteroscopic sterilization. Patients with nondiagnostic imaging for irregular or postmenopausal bleeding can have uterine cavity evaluation and biopsies performed with a simple office hysteroscopy. See-and-treat algorithms for irregular bleeding have been shown to be cost- effective and avoid procedures using general anesthesia in approximately 30% of patients.

Take a look at the Essure website for more information.

These two articles will also provide more insight:

Permanent contraception provides a lesson in cost-effective medicine.

Hysterocopic Sterilization

August 14, 2016 Office Procedures