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Despite the widespread use of the Internet and the emergence of social networks, diagnostic and surgical hysteroscopy has not been widely used in Ukraine until 2006. Since 2006 there has been a more active development of hysteroscopy, which is connected to the organization of a number of regular conferences devoted to gynecologic endoscopic surgery, with the involvement of international experts. It was 2006 that, in my opinion, became the year of Ukraine for the rapid development of gynecological endoscopy and hysteroscopy in particular.

From 2006 to the present day, the spread of hysteroscopy has steadily increased. To date, many public and private centers have in their arsenal hysteroscopes and hysteroresectoscopes. Since 2012, bipolar hysteroresectoscopy has started to develop actively. Diode lasers have been widely used since 2013. After 2015, shavers appeared in some places. In 2018, the first systems using 3 mm laparoscopic instruments for performing intrauterine manipulation have appeared.

Despite the huge growth spurt that hysteroscopy has had in our country, the issues of training and acquiring new equipment remain urgent. However, all gynecologists understand the importance and benefits of hysteroscopy, which makes 100% incorporation of this technique into our practice a matter of time. I hope, and I am even confident that office hysteroscopy, intrauterine operations in outpatient settings, laser technologies, hysteroscopic embryoscopy and many other kinds of hysteroscopy will become a "stethoscope" of Ukrainian gynecologists in the next five years. Progress is inevitable.

                                                                                         Mykhailo Medvediev

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Morocco is a developing country with a population of over 34 million today . The country has been seriously challenged by the scarcity of healthcare human resources over the past few decades, and there are currently less than 2000 Obstetrician-Gynecologists in total, leading to an unacceptable level of pregnancy and childbirth related deaths and morbidities. Our predecessors focused on adressing this issue but neglected the development of the fields of Gynecologic surgery and Fertility management.


As a young professor in the early nineties; I found this situation unacceptable. So I decided to resign and along with a small group of passionate colleagues we created the Moroccan Society of Gynecological Endoscopy (SMEGYN) and organized our first workshop with the support of our French colleagues, mainly Pr. Leon Boubli from Marseille and Pr. Jean-luc Mergui from Paris. The next step was to further develop Laparoscopic surgery, in collaboration with Pr Jean Bernard Dubuisson and the renowned team of Clermont-Ferrand.

Up until now, we organized 20 congresses, 11 courses of Hysteroscopic Surgery currently delivered by an exclusively Moroccan team, with over 400 participants in total, and 9 courses of Laparoscopic Surgery . Currently hysteroscopy is spreading throughout all the country. Regarding the technical aspects, diagnostic hysteroscopy is provided in an office setting by vaginal approach without anesthesia and the large majority of surgical procedures are scheduled in the OR, using a resectoscope. Short procedures are performed under general anesthesia and laryngeal mask or rachianesthesia for very long procedures such as large myomas or severe synechiae.

                                                                                         Jamal Fikri

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In the realm of minimally invasive options in gynecologic surgery and treatment, hysteroscopy remains an underutilized tool in the arsenal of the MIGS surgeon. Those of you who know me, know that educating my peers on the diagnostic and therapeutic power of hysteroscopic surgery and the benefits it has for our patients has been a foundation of my career for decades. Because of this, I couldn’t be more pleased to personally invite you to the first AAGL Global Hysteroscopy Summit, a program that was unanimously approved by the AAGL Board of Directors. The Summit will be held in one of my favorite Canadian cities, Toronto, July 27-28, 2018. 

I’m proud to be joined by hysteroscopic visionaries, innovators, and enthusiasts who will present novel new indications, discuss new technology, and have friendly debates. But it will also be my honor to thank a legend and pioneer, a humble leader who stoked and nurtured my initial interest in hysteroscopy, and whose early focus lead to an increased adoption of office and operative hysteroscopy worldwide – Dr. Franklin Loffer. His infectious energy and zeal lead him to teach thousands of individuals just like you and me. Join us as we celebrate his years of leadership, innovation, and service to the AAGL family.

The Global Hysteroscopy Summit will be a more intimate gathering than our Annual Global Congress, affording you the opportunity to meet all the speakers and have in-depth conversations. 
 

                                                                        Linda Bradley

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The field of hysteroscopic surgery has seen many advances over the years, from improved optics, the flexible hysteroscope, the resectoscope, hysteroscopic morcellators and most recently, the 5-mm “mini”-resectoscope. The art of hysteroscopy never stops to amaze me. The ability to perform a complex surgical procedure inside of the uterine cavity, without incisions, in the outpatient setting is revolutionary. Add to this the ability to achieve this without a speculum, tenaculum or cervical dilation; i.e. the vaginoscopic approach.

This technique provides several advantages, including avoiding a false track, decreased risk of uterine or cervical perforation, and minimizing trauma to the cervix and endometrium, avoiding the bleeding and debris, hence providing excellent visualization. I feel privileged to practice in this golden age of hysteroscopy, particularly with the coming-together of amazing hysteroscopic surgeons through the innovative Hysteroscopy Newsletter, the Global Congress of Hysteroscopy and the many successful hysteroscopic summits and congresses organized throughout the globe.

 

Nash Moawad

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Hysteroscopy has broadened our understanding of the pathology of the uterine cavity and endometrium, the intramural diseases and the physiology of the uterus. It accelerated our understanding of many areas such as the growth and regeneration of endometrium and the biology of endometrial stem cells. More specifically, treating myomas with hysteroscopy allows us to understand the histology and biological characteristics of the myometrium such as the distribution of blood vessels and the anatomy of the muscular layers, which helps surgeons minimize tissue damage during operations. We also have a better understanding of the biology of precancerous endometrial lesions and endometrial cancer. This may bring revolutionary changes in the treatment for local and early stage endometrial cancer in the future. Similar changes may also take place in treating intramural lesions such as adenomyosis..

To conclude, surgical hysteroscopy has already caused a revolution in the diagnosis and treatment of uterine intracavitary pathology. Advances in technology has made the surgeries of uterine cavity easier, safer and possible in the office settings. Advanced artificial intelligence, optical technology and ultrasonic technology will lead to more intelligent and efficient hysteroscopy, change the diagnostics and treatments of endometrial and uterine diseases, and bring about new perspectives to the related diseases.

Xiang Xue