Teaching Hysteroscopy by Multimedia

Audio/Video Link  *requires RealPlayer - free download

Dr. Hugo Verhoeven:  “We’re talking today with Dr. Yves Van Belle who is world famous for his work in the field of hysteroscopy.  He’s a Board Member of the International Society of Gynecological Endoscopy, and he’s working at St. John’s Hospital in Brussels.  Yves, it is a real pleasure talking to you.”

Dr. Yves Van Belle:  “Thank you.”

Dr. Hugo Verhoeven:  “I know that you’ve worked about 20 years performing ambulatory hysteroscopic diagnostic procedures and also surgical procedures so it was time for you, I think, to make a complete overview of what is possible in the field of hysteroscopy today.  You didn’t do that by editing a book but by editing a CD-ROM, and the aim of that was to show people or to teach people hysteroscopy with multimedia.  I saw the video and I was very impressed that about 40 worldwide famous collaborators worked on the book.  You had about 700 pictures in it and about half an hour of videos so let’s go over the book quickly together.  You talk about the basics, about the indications for hysteroscopy, the diagnosis, the therapy possibilities, and a very interesting final chapter on self-evaluation with questions and answers to know exactly what we know about hysteroscopy.  So let’s talk about basics.”

Dr. Yves Van Belle:  “I would like to say first to what you said, I always thought the teaching in hysteroscopy was extremely important and that in these modern times we have to use the multimedia.  That is the reason why we developed this CD-ROM, and as you said before with the contribution of more than international contributors who were rightly called by Dr. Indman, the international who’s who in hysteroscopy.  I think it’s important to say that because that means that we have a comprehensive work that shows not only the ideas of one author but it gives an overview.  In the same way we wanted this work to be as comprehensive as possible, and that’s the reason why we started with the basics.  Although for a lot of people it could be rather boring, we think it’s important that you have your basics because in all the operative time we tend to forget those basics and that brings a lot of problems along.  So the basics go over equipment, imaging, high-frequency currents, and over the technique of hysteroscopy of course.” 

Dr. Hugo Verhoeven:  “What do you think is the advantage of a CD-ROM compared with a book in teaching?” 

Dr. Yves Van Belle:  “It has a lot of advantages in that it can be used as well for teaching other people than for self-teaching.  You can go through this CD-ROM at your own level and on your own time and search for those topics that are of interest to you.  It’s clear that the novice who is starting with hysteroscopy will take another path than the experienced gynecologist.  It also has a lot of features which are not specifically for this CD-ROM but which are in general that you can go very easily back and forward without having to go through pages and pages as you have to do in a textbook.”

Dr. Hugo Verhoeven:  “Let’s go back to the contents of your CD-ROM now.  In the next chapter, you give an overview of the indications for hysteroscopic treatments.  Would you give us some details about that?”

Dr. Yves Van Belle:  “Yes, once again, we tried to be as comprehensive as possible.  We’re starting of course with abnormal uterine bleeding which every gynecologist knows is a very frequent indication but also going over items like suspicion of lesions indicated by other techniques such as ultrasound or whatsoever.  We’re trying each and every time to say what hysteroscopy could possibly bring more of.  It’s not our aim to say that hysteroscopy should be the only technique or is the only technique that brings some information, just to show what it can bring more of.  That goes for infertility, embryoscopy, and also for oncology of course.“

Dr. Hugo Verhoeven:  “A very important chapter to me it seems is the possibilities and also the limits of hysteroscopy.  I think you should stress this very clearly to us.”

Dr. Yves Van Belle:  “The first thing we say about diagnosis in the chapter of diagnosis is actually that, once again, it’s not the only examination but it is an examination as all the others that has its possibilities and its limits, and to one starting with hysteroscopy and also those performing hysteroscopy have to be very careful not to forget that it has possibilities but also its limits, and that goes for as well the congenital as the acquired pathology.”

Dr. Hugo Verhoeven:  “So what are the limits of hysteroscopy?”

Dr. Yves Van Belle:  “For instance, there is a very important part about diagnostic of the endometrium because the endometrium is the thing that we can examine the best during hysteroscopy.  There, for instance, we are warning that you should not confuse histology with hysteroscopy and that is one of the limits of hysteroscopy.  Another limit, of course, is that up till now hysteroscopy doesn’t give any information about pathologies inside the uterine wall, I’m thinking about adenomyosis, intrauterine myomas, intramural myomas, and also talking about the grade of invasion of adenocarcinoma inside the uterine walls so that’s a few examples of the limits of hysteroscopy.”

Dr. Hugo Verhoeven:  “The next chapter is on therapy.”

Dr. Yves Van Belle:  “Yes, specifically regarding the therapy, we always kept in mind that this was to be a teaching instrument.  If I might give you the example of a myoma resection, this operation has been divided; it has been split up in very small parts just to show the one who is learning to perform this operation what the difficulties are, what the specific features of each and every step of the operation are, and also warning once again for the risks and giving possibilities to avoid complications.”

Dr. Hugo Verhoeven:  “The last chapter is the self-evaluation of our knowledge on hysteroscopy.  I’ve never seen that before.  What was the reason for you to do that?”

Dr. Yves Van Belle:  “The reason we did it is, one, we never saw it before and, secondly, because we thought it could be wise to judge afterwards for yourself what you picked up and what you already know.  So you could do this self-evaluation model before reading the CD-ROM and then once again after the CD-ROM just to see if there is any progression.  You can do it for yourself or you can do it for your students.”

Dr. Hugo Verhoeven:  “I also saw that you gave in your CD-ROM the possibility to add to your personal notes and that is also very special.”

Dr. Yves Van Belle:  “This is for me one of the most important things that each and everyone can notice on this hard disk - what he thinks about certain images and what he wants to rethink from a certain chapter.”

Dr. Hugo Verhoeven:  “This CD-ROM contains a lot of information.  If you would compare it with the information in a book, how many pages would you need for a hard copy?”

Dr. Yves Van Belle:  “It would almost be an encyclopedia.”

Dr. Hugo Verhoeven:  “An encyclopedia.”

Dr. Yves Van Belle:  “I don’t have any correct figures but it has been figured out that it would be an encyclopedia.”

Dr. Hugo Verhoeven:  “Is it exaggerated to say that this is the bible of hysteroscopy?”

Dr. Yves Van Belle:  “That is actually what Professor Lindermann called it, a digital bible of hysteroscopy.  There’s something more I want to add to it before we forget it which I think is very important, in the CD there is also a separated index for the nurses because we are going out from the idea that endoscopy is team work and you cannot perform and have good results without having a motivated and well-informed team of nurses around you so that’s the reason why this CD-ROM contains a specific index for the nurses.”

Dr. Hugo Verhoeven:  “It’s always very interesting for our readers to know where they can buy this CD-ROM and what is the cost of it?”

Dr. Yves Van Belle:  “Actually, as I said before, we tried to be comprehensive and we tried not to be dependent on one or another company but actually it is at this moment the Olympus Company who is distributing it.”

Dr. Hugo Verhoeven:  “So it’s not for sale?”

Dr. Yves Van Belle:  “It is for sale but through the Olympus Company.  Regarding the price, I won’t say anything because from the beginning I always separated the scientific and medical part of it with, let’s say, the marketing part of it so people who want to have this CD-ROM just contact their local Olympus dealer.”

Dr. Hugo Verhoeven:  “My final question is just a remark on my own experience, you know that I’m a reproductive endocrinologist and specialized in vitro fertilization.  In my country where I’m working, we see that hysteroscopy is still not performed by that many doctors.  Why is that?  It’s a simple and cheap technique, and it sometimes brings an enormous amount of information.  Why is it that not that many people are performing hysteroscopists?”

Dr. Yves Van Belle:  “I don’t agree with you that it’s always been a simple technique, it was difficult at the beginning.  It has to do with the uterus itself; we have problems of distention which urologists don’t have because the bladder is easy to distend so that’s the first historical reason why it didn’t advance that much.  On the other hand, right now there has to be a supplementary investment for the one who wants to do hysteroscopy, which in these times could also be a major problem.  I think the third point was that there was actually a lack of information and a lack of education in hysteroscopy, and that’s the reason why we hope that with this product we could help a little bit.”

Dr. Hugo Verhoeven:  “I hope that your CD-ROM will be a contribution in the fact that in the future more and more gynecologists will be actively performing hysteroscopy.  Thank you very much, Yves.”

Dr. Yves Van Belle:  “My pleasure.”

*To order a copy of Dr. Van Belle's "Modern Clinical Technical Hysteroscopy" (catalog#CD-MCTH) contact Olympus America Inc. Surgical Products Division 1-800-548-5515 or email SPDINFO@OLYMPUS.com  America Inc.
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1-800-548-5515