Keith B. Isaacson, MD
MIGS, Newton-Wellesley Hospital
Harvard Medical School
Boston, Massachusetts

Hi, my name is Keith Isaacson. I’m 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.

It’s 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.

It’s a very exciting time, in that the field of obstetrics and gynecology is changing, and it’s 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, it’s less time to return to her normal activities—often the same day after these procedures. And it’s 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 procedures.

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 there’s 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.