Office-Based Operative Hysteroscopy: Selection, Skills, Success.

Office-based operative hysteroscopy (Op-HSC) offers direct visualization and immediate treatment of intrauterine pathology. Modern hysteroscopic equipment and hysteroscopic tissue removal systems have expanded the range of lesions that can be treated in the office setting. By offering an alternative to the operating room, office-based Op-HSC reduces surgical wait times and improves patient satisfaction. Yet, the technique remains under-utilized, largely due to suboptimal candidate selection, inadequate clinician training, and concerns about patient discomfort. The current narrative review summarizes contemporary evidence on equipment, patient selection, anxiolysis and analgesia, and surgical and reproductive outcomes for office-based Op-HSC.