To evaluate the performance of arthroscopic “NanoScope” technology when adapted for gynaecological endoscopy (vaginoscopy and hysteroscopy), and consider its potential application in the gynaecological space.

Design:

6 patient video case series (4 included for video abstract)

Setting:

Despite reportedly high patient acceptability rates, outpatient hysteroscopy has very low uptake in Australia. Reasons for this might include concern for patient discomfort, poor access, and resource/equipment requirements.

Our case series examined the usability and image quality of compact, portable, ultra-thin NanoScope technology as a substitute for standard hysteroscope under general anaesthetic.

Patients or Participants:

Patients already undergoing diagnostic or therapeutic hysteroscopy were recruited for optical endometrial evaluation using NanoScope. Standard hysteroscopic examination was also used to ensure equivalence of findings.

Interventions:

The 1.9mm (0.07in.) diameter NanoScope with handpiece contains a fibre optic bundle with LED light and high-resolution camera sensor which connects to a laptop-style hard drive and display console. The scope was introduced into the uterine cavity using a 2.2mm (0.09in.) diameter fluid-introducing sheath for saline hydrodistension. Still and video images were obtained for quality evaluation.

Measurements and Main Results:

Images obtained via NanoScope (as per accompanying video abstract) were of equivalent diagnostic utility to standard hysteroscope. NanoScope was readily adaptable to vaginoscopy and hysteroscopy, easy to use and produced high-quality images for intra-cavitary diagnosis. It passed easily into the cervical canal and uterine cavity without need for cervical clamping or dilatation.

Conclusion:

NanoScope technology offers an exciting potential alternative to traditional inpatient or hospital-based diagnostic hysteroscopy. The compact system and ultra-thin scope may have a place in office-based point-of-contact hysteroscopy in future practice. Potential benefits include improved patient comfort, reduced demand on hospital resources and cost-savings to both patients and the healthcare system.

Further research is needed to study patient acceptability and feasibility of the device in the outpatient hysteroscopy setting.