The history of the hysteroscopy and Prof. Bettocchi are linked forever. The vaginoscopic approach as well as his 5 mm hysteroscope were the first step of the modern hysteroscopy.
How did you developed the vaginoscopy approach?
The vaginoscopic approach was developed in ’92 as an answer to my experience abroad and to the need to overcome the shortage of anaesthetists we used to have; actually in those days we still had to access the operating theatres for the anaesthesia and due to the shortage of anaesthetists and the growing number of patients, we decided to find a way to hysteroscopy and finally strip down our patients’ discomfort. Back then, there were more and more nuns accessing our institute and this fact motivated us even more to find a non-invasive access to the cervical canal.
The first vaginoscopies were executed even before to develop an outpatient procedure, when the hysteroscopies were still executed with CO2, so just imagine how difficult it could be to do vaginoscopies with gas! Only during the following years, with the new hysteroscopes, we could use the liquid and so standarise the technique to make it reproducible.
You have design some new devices for hysteroscopy, do you have any other tool in mind?
Yes, actually we have many projects going on, but, actually, for the company it is impossible to manage all them at the same time, so we are now prioritising them and I hope you will see something new very soon. Anyway, the latest innovations have been the Integrated Hysteroscope (B.I.O.H.) and the amazing suction/irrigation device (pump) called Hysteromat E.A.S.I.
There is a growing interest in hysteroscopy, what can we do to promote the hysteroscopy?
Well, non-enthusiasts commonly consider hysteroscopy just a secondary and minor procedure. So we shall first of all "convert" them and make them to understand that they are in front of a very important and valuable procedure. Furthermore, hysteroscopy is in the hands of the youngest gynaecologists who consider this technique suitable for them against laparoscopy; then we shall try to have an effect on the young blood!
In your opinion, which is the best way to become a skilled hysteroscopist?
Definitely not the do-it- yourself. In fact many colleagues, due to the lack of skilled hysteroscopists, they rely just on info they can obtain during some congresses and courses and on their own "attempts"; they try their own luck. Well, we should make sure we have experts in each country so that we can have experts everywhere able to teach; we can not limit the teaching task to super-experts coming from abroad.
Has hysteroscopy reached its limits?
I don’t think so. The clinical pathologies are well defined because we know the uterine cavity very well, but we have to keep working on the improvement of the technology to solve even more rapidly and efficiently these pathologies
Please give us your future reflections in regards to hysteroscopy.
As I have just said, my reflections are not just based on pathologies, but on what we should do in order to standardise these procedures and research new procedures for our daily activities.
I personally think that this question can be of interest for too many people. Do you have any advice for the young physician who is starting out in the world of surgery?
First of all, I would suggest him to be passionate: passion can make the difference. The young physician should learn and listen to experts but, at the same time he should not be passive in the learning process. He should try to be innovative also when he is onlyvrepeating activities he has learned or seen from experts. This is my own story, I could have been a clone of my maestro, but I was always looking for new solutions in my reality.
So, do respect your teaching experts, but always look for something new discovering and sometimes overcoming your limits!