Basic Hysteroscopy

Simulation

Materials

• Station ideally has two residents and one faculty preceptor
• Medical equipment per station:
  • Endoscopic tower
  • Diagnostic hysteroscope
  • 1000 cc bags 0.9% NaCl (not necessary if running a dry lab)
  • Tubing for inflow and out flow (not necessary if running a dry lab)
  • Uterine model: can often be obtained from local Ethicon rep uterine model trays
  • Bell pepper (one per resident)*
  • Grasping forceps and scissors (only for bell pepper lab)

Lab Sequence

The intended sequence of events for this lab involves two initial OSATS (observed structured assessment of technical skills):

1. Five-minute hysteroscope assembly OSATS 
2. Five-minute diagnostic hysteroscope OSATS or 10-minute bell pepper lab

The faculty should make certain that none of the equipment is damaged and only intervene if damage to the equipment appears imminent.

Competency Assessment

Hysteroscope Assembly

• Residents should be able to assemble the hysteroscope correctly and obtain an image in less than five minutes to be considered competent in this task
• Correctly naming and proper order of assembly will be noted as mastery of this task

Diagnostic Hysteroscopy

Residents should be able to:

• Identify cervical canal, junction of canal and lower uterine segment and both tubal ostia
• Identify each of the intrauterine pathologic features in less than five minutes in order to be considered competent
• Properly rotate the scope to maximize the use of the angled lens and minimize uterine manipulation and torque

Bell Pepper Lab

Residents should be able to:

• Identify the seeds and septa
• Remove three seeds with a grasper and excise a 1cm segment of the septa to be considered competent
• Properly rotate the scope to maximize the use of the angled lens not dropping any seeds and excising the septa segment all without any redundant moves (will be considered mastery)