Clinicians’ Experience with Endosee Office Hysteroscopy


Allows Physicians & Patients To Move Further Down The Diagnostic Algorithm

“Whether it’s seeing something or not seeing something, Endosee allows both physicians and patients to move further down the diagnostic algorithm or pathway. Patients are so appreciative that they can see and know exactly what’s going on instead of having to come back for a follow-up visit or wait for a laboratory result. By using it, you realize that you’re doing patients a service by getting to a diagnosis as soon as possible.”

“In addition to offering physicians immediate visualization to gather important diagnostic information, Endosee also allows us to perform an endometrial biopsy and hysteroscopy in the same visit.”

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Ethan Goldstein, MD

  • Ethan Goldstein, MD
  • Robotic & Minimally Invasive Surgery Program
  • Huron Valley-Sinai Hospital, Detroit, MI

An In-office Approach is Now More Economically Valuable

“Dramatic shifts within the Centers for Medicare & Medicaid Services fee schedule in 2017 – and commensurate changes in the private insurance market – have now ramped up [the value of in-office hysteroscopy]…The benefits of integrating hysteroscopy into office practice have been compelling for some time. An in-office approach is patient centered, more efficient, and clinically valuable. It also has had the potential to be economically valuable for practices that are able to perform a mix of diagnostic and therapeutic/operative hysteroscopies.”

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Aarathi Cholkeri-Singh, MD

  • Aarathi Cholkeri-Singh, MD
  • University of Illinois, Chicago, IL
  • Advocate Lutheran General Hospital, Park Ridge, IL

Increase in Reimbursement Encourages In-Office Hysteroscopy

“[Before January, 2017,] higher procedural costs in the office…actually discouraged the physician who wanted to perform cases in the office. [The] increase in the reimbursement for hysteroscopic endometrial biopsy and/or polypectomy…creates a distinct monetary advantage, which along with increased physician efficiency and patient comfort, has led to more physicians bringing these surgeries to an in-office setting.”

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Charles E. Miller, MD

  • Charles E. Miller, MD
  • University of Illinois, Chicago, IL
  • Lutheran General Hospital, Park Ridge, IL

The Standard of Care Has Changed

The standard of care has changed. Now the standard of care corroborates that a negative blind biopsy is not a stopping point. Clinicians can still begin with a blind biopsy, but unless it is malignant or complex atypical hyperplasia, the endometrial evaluation is not complete. One of the take-home messages is getting away from this over-reliance on blind biopsy as the first and last word in all these cases.”

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Steven R. Goldstein, MD

  • Steven R. Goldstein, MD
  • New York University School of Medicine
  • New York, NY

A More Thorough Evaluation, Faster Diagnosis

“I had a patient with persistent post-menopausal bleeding with a normal endometrial biopsy and transvaginal ultrasound, but I decided to also use Endosee because it is so easy to set up and poses such a low risk. Much to my surprise, I ended up finding one of the largest endometrial polyps I have ever seen. I would never have found this polyp had I not used Endosee since I probably would not have taken her to the OR or even done office hysteroscopy because I thought I wouldn’t find anything. But because Endosee is so quick and easy to use, I found significant pathology, treated the patient and her symptoms are completely resolved.”

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Abigail T. Feathers, MD

  • Abigail T. Feathers, MD
  • Specialty Physicians of Garrett County
  • Oakland, MD

Clearer Visualization than Pelvic Sonogram

“Endosee allowed myself and the patient a direct assessment of the uterine cavity. We were both surprised to see the reoccurrence and extent of intrauterine pathology that I was not able to appreciate on pelvic sonogram. This patient is scheduled for a second Endosee after discontinuing the oral contraceptives to see if the polyps resolve. If not, she will be scheduled for a second, operative hysteroscopy.”

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Steven Lindheim, MD, MMM

  • Steven Lindheim, MD, MMM
  • Wright State University
  • Boonshoft School of Medicine Dayton, OH

“This handheld, portable system can be set up in minutes and in any examination room, so it is not disruptive to my practice or my patients.”

Ethan Goldstein, MD
  • Ethan Goldstein, MD
  • Robotic & Minimally Invasive Surgery Program
  • Huron Valley-Sinai Hospital, Detroit, MI

“Endosee brought about a mind-set change. By using it, you realize that you’re doing patients a service by getting to a diagnosis as soon as possible.”

Ethan Goldstein, MD
  • Ethan Goldstein, MD
  • Robotic & Minimally Invasive Surgery Program
  • Huron Valley-Sinai Hospital, Detroit, MI

“In addition to offering physicians immediate visualization to gather important diagnostic information, Endosee also allows us to perform an endometrial biopsy and hysteroscopy in the same visit.”

Ethan Goldstein, MD
  • Ethan Goldstein, MD
  • Robotic & Minimally Invasive Surgery Program
  • Huron Valley-Sinai Hospital, Detroit, MI

“Dramatic shifts within the Centers for Medicare & Medicaid Services fee schedule in 2017 – and commensurate changes in the private insurance market – have now ramped up [the value of in-office hysteroscopy]… According to national payment amounts, performing this procedure in the office earned an average of $1,382.07 in 2017, compared with $409.60 in 2016.”

Aarathi Cholkeri-Singh, MD
  • Aarathi Cholkeri-Singh, MD
  • University of Illinois, Chicago, IL
  • Advocate Lutheran General Hospital, Park Ridge, IL

“The benefits of integrating hysteroscopy into office practice have been compelling for some time. An in-office approach is patient centered, more efficient, and clinically valuable. It also has had the potential to be economically valuable for practices that are able to perform a mix of diagnostic and therapeutic/operative hysteroscopies.”

Aarathi Cholkeri-Singh, MD
  • Aarathi Cholkeri-Singh, MD
  • University of Illinois, Chicago, IL
  • Advocate Lutheran General Hospital, Park Ridge, IL

“In addition to reimbursement levels, it’s important to consider the efficiencies of in-office hysteroscopy. The setup is relatively simple and requires a dedicated exam room, not a surgical suite... Hysteroscopy at the hospital, or even at an ambulatory surgical center, involves time driving, changing, and waiting for anesthesia.”

Aarathi Cholkeri-Singh, MD
  • Aarathi Cholkeri-Singh, MD
  • University of Illinois, Chicago, IL
  • Advocate Lutheran General Hospital, Park Ridge, IL

“For our patients… an in-office approach offers less out-of-pocket expense (deductibles), less time away from family/work, avoidance of general anesthesia/intubation, and greater patient comfort from being within a familiar environment. For diagnostic procedures, the patient can be in and out in less than 30 minutes, and for operative procedures, she can be in and out in 1-2 hours, compared with more than 4 hours at the hospital.”

Aarathi Cholkeri-Singh, MD
  • Aarathi Cholkeri-Singh, MD
  • University of Illinois, Chicago, IL
  • Advocate Lutheran General Hospital, Park Ridge, IL

“[Before January, 2017,] higher procedural costs in the office…actually discouraged the physician who wanted to perform cases in the office. [The] increase in the reimbursement for hysteroscopic endometrial biopsy and/or polypectomy…creates a distinct monetary advantage, which along with increased physician efficiency and patient comfort, has led to more physicians bringing these surgeries to an in-office setting.”

Charles E. Miller, MD
  • Charles E. Miller, MD
  • University of Illinois, Chicago, IL
  • Lutheran General Hospital, Park Ridge, IL