{"id":177,"date":"2026-10-28T11:45:54","date_gmt":"2026-10-28T01:45:54","guid":{"rendered":"https:\/\/escope.ages.com.au\/november-2026\/?p=177"},"modified":"2026-10-28T14:52:12","modified_gmt":"2026-10-28T04:52:12","slug":"outpatient-hysteroscopy-across-borders-lessons-from-a-travelling-fellowship","status":"publish","type":"post","link":"https:\/\/escope.ages.com.au\/november-2026\/outpatient-hysteroscopy-across-borders-lessons-from-a-travelling-fellowship\/","title":{"rendered":"Outpatient Hysteroscopy across borders: Lessons from a travelling fellowship"},"content":{"rendered":"\n

\n\t\t\tOutpatient Hysteroscopy across borders: Lessons from a travelling fellowship\t<\/h1>\n\t\t\t

After establishing and managing Liverpool Hospital’s first outpatient hysteroscopy clinic (OHC), I applied for the Hologic Hysteroscopy Travelling Fellowship with a clear objective:<\/h3>\t\t\t\n\t\t\t\t

to learn from established services and identify practical improvements for our own clinic. Establishing the service had been made possible by the support of our exceptional Head of Department, Dr Ian Fulcher and our dedicated clinical nurse manager Ms Hazel Cuaresma and nursing team.<\/p>\n

I hoped to gain both Australian and international perspectives – a goal realised with the support of the Hologic team. My fellowship included the Outpatient Hysteroscopy Workshop at Mercy Hospital in Melbourne, a Medical Education Clinical Immersion Day at Gold Coast University Hospital, and visits to several sites in British Columbia, Canada.<\/p>\n\t\t\t

Lessons from Mercy Hospital, Melbourne<\/h3>\t\t\t\n\t\t\t\t

At Mercy Hospital, I observed the benefits of the Gracie gynaecological chair by LINET, which supports patient comfort and converts seamlessly into an examination position. Although it offers advantages in efficiency and clinical ergonomics, it represents a considerable initial investment.<\/p>\n

The visit also highlighted the value of sharing clearly defined inclusion and exclusion criteria across relevant clinical areas to support appropriate referrals and raise awareness of the service. Discussions with clinicians at the Outpatient Hysteroscopy Workshop provided further ideas for improving patient acceptability and refining surgical techniques.<\/p>\n

\n\t\t\t\t\t\"Vinita-1\n\t<\/figure>\n\t\t\t

Lessons from Gold Coast University Hospital<\/h3>\t\t\t\n\t\t\t\t

The Gold Coast team shared effective strategies for securing funding to expand and sustain a service, as well as for acquiring essential equipment such as OmniScope trays. Their model illustrated the viability of a see-and-treat clinic and highlighted how consent proformas can streamline clinical practice. Attending the Clinical Immersion Day alongside members of our nursing team encouraged collaborative learning and generated shared ideas for improving our unit.<\/p>\n

I also observed the team performing outpatient endometrial ablations and had the opportunity to learn their technique for administering an intrafundal block. The equipment comprised a 10 mL syringe connected to a three-way tap and a Cooks needle, which passed readily through the operative hysteroscope. An assistant operated the tap and administered lignocaine while the surgeon stabilised the needle within the myometrium. On returning to Liverpool Hospital, I practised the technique during procedures under general anaesthesia to build familiarity and confidence.<\/p>\n

\n\t\t\t\t\t\"goldcoast-university-hospital-001\"\n\t<\/figure>\n\t\t\t

Lessons from British Columbia, Canada<\/h3>\t\t\t\n\t\t\t\t

The Canadian teams introduced me to “slates” – their term for surgical lists – and to a pain-management approach that differed from my previous experience. At one clinic I visited, intravenous fentanyl and midazolam were administered without an anaesthetist present. The outpatient setting also lacked immediate access to a medical emergency team. Although this was established practice at that site, it was unfamiliar to me. The patients I observed appeared calm and comfortable throughout their procedures.<\/p>\n

Four nurses fulfilled distinct roles: surgical scrub, patient observations and documentation, circulating duties, and medication administration. This staffing and pain-management model appeared to support longer procedures while maintaining patient comfort and efficient patient flow.<\/p>\n

Procedures included diagnostic and operative hysteroscopy using OmniScopes, endometrial ablation, and resection of a FIGO type 2 fibroid using intramyometrial carboprost. The team used a Deflux\u00ae metal needle for intramyometrial infiltration, which prompted me to consider its potential application for intrafundal blocks.<\/p>\n

The team generously shared their pain-management protocols. However, I remain cautious about adopting this approach without an anaesthetist present.<\/p>\n

\n\t\t\t\t\t\"Jim\n\t<\/figure>\n\t\t\t

Reflection<\/h3>\t\t\t\n\t\t\t\t

Each visit reinforced the progress already made by our developing service at Liverpool Hospital. Equally valuable was the opportunity to reflect on our practice, consider how ideas from other centres might translate to our setting, and identify further opportunities for growth.<\/p>\n

Since returning to the West Coast, I have shared insights from Canada with my East Coast colleagues. I look forward to hearing about their progress in introducing outpatient endometrial ablation, increasing the number of surgical lists, and expanding training opportunities for core RANZCOG trainees.<\/p>\n

Following maternity leave, I am eager to work with my West Coast team to further develop operative hysteroscopy options. Together, managing the OHC and undertaking the travelling fellowship have been among the most rewarding experiences of my AGES training. I am grateful for the perspectives gained and the opportunities to strengthen my leadership and service-development skills.<\/p>\n

\n\t\t\t\t\t\"dr-vinita-rajadurai-001\"\n\t<\/figure>\n\t\t\t\t

Dr Vinita Rajadurai<\/strong>
MBBS DRANZCOG FRANZCOG
AGES Accredited Surgeon
Joondalup Obstetrics & Gynaecology Group\u00a0
Fiona Stanley Hospital<\/p>\n\n","protected":false},"excerpt":{"rendered":"

Together, managing the OHC and undertaking the travelling fellowship have been among the most rewarding experiences of my AGES training.<\/p>\n","protected":false},"author":1,"featured_media":72,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"site-sidebar-layout":"no-sidebar","site-content-layout":"","ast-site-content-layout":"full-width-container","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[1],"tags":[],"class_list":["post-177","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorised"],"acf":[],"_links":{"self":[{"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/posts\/177","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/comments?post=177"}],"version-history":[{"count":4,"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/posts\/177\/revisions"}],"predecessor-version":[{"id":224,"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/posts\/177\/revisions\/224"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/media\/72"}],"wp:attachment":[{"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/media?parent=177"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/categories?post=177"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/tags?post=177"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}