Keith B. Isaacson, MD
MIGS, Newton-Wellesley Hospital
Harvard Medical School
Hi, my name is Keith Isaacson. Iím a Director of Minimally Invasive Gynecologic
Surgery and Infertility in Newton-Wellesley Hospital in Newton, Massachusetts and
Associate Professor of Obstetrics and Gynecology at Harvard Medical School.
Itís my pleasure to be here this morning and to discuss the activities from the
standpoint of the AAGL and promoting office-based procedures and office-based hysteroscopy.
To discuss the role the AAGL has in educating physicians to learn these new procedures,
as well as educating patients to let them know these kinds of procedures are available
and that they will hopefully ask their clinicians about these new procedures.
Itís a very exciting time, in that the field of obstetrics and gynecology is changing,
and itís changing for a variety of reasons, most of them for the better. And what
is happening is that there are many procedures that have previously been done in
the operating room that can now be done safely and comfortably in an office-based
setting. And this has benefits for the patient, in that it requires less time for
the patient to take out of her daily life, out of work, itís less time to return
to her normal activities—often the same day after these procedures. And itís
much more efficient for the clinical practice of the physician. Some examples of
these procedures include:
• performing diagnostic hysteroscopy
• performing hysteroscopic tubal occlusion or permanent sterilization
• performing the evaluation of menopausal patients who have abnormal bleeding, who
might have cancers or precancers
• removing lesions in the uterus and the vagina that can cause bleeding in patients
who are premenopausal, including polyps and some small fibroids.
To do these procedures in the office, to do them safely and comfortably, requires
new technology to be developed by industry, as well as it requires new techniques
to be taught to the clinicians. And this is where the AAGL has played a crucial
and a pivotal role—in encouraging industry to develop these new technologies,
as well as supporting hysteroscopic courses to teach physicians how to do these
So, for example, we had a postgraduate course that had about 100 participants, in
which they came and learned the techniques that were available and then actually
had a hands-on laboratory session. The participants who were at the hands-on course
for office-based procedures and office hysteroscopy yesterday—many of them
were not aware that these procedures could actually be done in the office and could
be done with minimal or no anesthesia necessary for the patients. And thereís no
question that it created an air of excitement for the participants. And I feel very
confident that these clinicians, after participating, will be able to go home and
offer it to their patients immediately.
And this has been the history of the AAGL—to be at the forefront of new technologies
that benefit the patients, that benefit the surgeons and clinicians. And I look
forward to continuing to work with the AAGL, to continue this endeavor.