Why Are We The Only Ones?

Why are we the only ones performing Ultrasound Guided Reoperative Hysteroscopy Surgery (UGRHS) for endometrial ablation failure?

So why are you the only one? It’s a question I often get asked from women across the country and abroad.

Let me try and explain this complex issue and why you don’t find this procedure readily available around the country—at least not yet.

  1. The procedure known as ultrasound-guided reoperative hysteroscopic surgery (UGRHS) requires a great deal of experience in traditional resectoscopic or hysteroscopic surgery. Many of these skills were lost with the introduction of Global Endometrial Ablation techniques (NovaSure, Hydrothermal Ablation, ThermaChoice and Minerva). To date we have performed nearly 3500 major operative hysteroscopic procedures of which 450 are reoperative procedures. But, it was the experience we gained–as far back as 1988–in operative hysteroscopy that provided us the skill necessary to progress to the point where we could safely offer UGRHS.
  2. Ultrasound-guided reoperative surgery also requires ultrasound expertise. Ultrasound has been incorporated into our practice since 1993. We do not employ ultrasound technicians—we perform our own ultrasound examinations. Amy Daggett—our very skilled nurse practitioner—and I have worked together since 1986 and have extensive experience in both ultrasound and ultrasound-guided surgery. Most sonographers that one finds in Ob Gyn Departments and in radiologist’s office have little or no experience in ultrasound-guided surgery. Between the 2 of us we perform thousands of ultrasound examinations per year and hundreds of procedures every year under ultrasound guidance.
  3. We have assembled a “team” that includes one R. N, a nurse practitioner, and 3 highly trained operating room technicians that have worked together for many years.
  4. Because we have a large volume of cases we are able to maintain our skills. Our practice performs nearly 200 major operative hysteroscopic procedures and at least as many “minor” hysteroscopic procedures per year.
  5. Honesty and integrity. Finally, none of this matters if can’t provide a service and do so with honesty and integrity. Let’s face it we, as physicians, live in glass houses. Word of mouth and the internet advertise both good and bad results—quickly. Ultrasound Guided Reoperative Hysteroscopic Surgery IS NOT FOR EVERY WOMAN THAT HAS AN ENDOMETRIAL ABLATION FAILURE. There are many women who are better off with the alternatives—including hysterectomy. What we do provide is accurate information that is tailored to your particular case. We refer many women every months for other management strategies. Ultimately our reputation is dependent on honesty and not promising what we cannot deliver.