Facility and Space for the Program

The space required for a hysteroscopic procedure room will vary somewhat with the planned procedures. The room should be designed and decorated in a fashion that maintains privacy to the extent possible, has proximity to a toilet and allows for temporary storage of patient clothes. Of course there must be space for the procedure table, the equipment and supplies, and for the surgeon, assistant and other individuals including a significant other as well as observers and trainees if that is part of the mission of the program.  

However, for more complex systems, and when multiple devices are required – such as fluid management, radiofrequency generators, electromechanical morcellators or endoscopic “towers” – multiple outlets may be required. These should preferably be positioned above the level of the floor to minimize the risk that fluids or moisture associated with hysteroscopic procedures interfere with electrical function.  

It will be necessary to have an appropriately positioned sink in the room with hot and cold running water. It is desirable to have a restroom in a proximal location. Ideally there will be direct access for the patient between the toilet, the change area and the procedure area.  

While an operating room light is unnecessary, it is important to have whatever combination of natural and artificial light is necessary to illuminate the patient and the equipment. And the light should be readily controllable and adjustable in a fashion that doesn’t require anyone to leave the room. An examination light will be necessary when a speculum is used to expose the cervix. 

The procedure table should be positioned in a fashion that protects the patient in the lithotomy position from being exposed should the door be opened. If this is difficult, a strategically positioned ceiling mounted curtain or portable room divider may work for this purpose. It is useful to have a chair for the accompanying individual be positioned near the head of the procedure table in a fashion that does not impede the procedure yet allows easy egress should it be necessary. Sometimes the accompanying individual will need to leave the room. Imaging equipment should be positioned in a fashion that allows the surgeon and individuals in the room to see the monitor yet provide access for the staff. Such proximity is necessary for other equipment as well, including electromechanical morcellators, radiofrequency electrical generators, fluid management systems and ultrasound units if used. 

When no or local anesthesia is used recovery areas are generally not necessary. However, some patients have needs for resting and recovering and it is ideal if this is done in a separate room near the procedure room. This should be an examination or other room with a bed to allow recovery from vasovagal episodes, episodes of nausea and vomiting or other symptoms. Blood pressure cuff and other basic equipment should be present. The capacity for relaxing music to facilitate the recovery is useful as is a seating area for the accompanying family member or friend.