2023年度日本産科婦人科内視鏡学会認定子宮鏡技術認定医動画審査結果の検討―子宮鏡技術認定医動画審査結果から見えてきたこと―

抄録

Purpose: In 2004, the Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy established a certification system for gynecologists of endoscopy (hysteroscopy). This year marks the 20th anniversary of the certification system. By analyzing the results of the hysteroscopy video evaluations for 2023, this study aimed to clarify important considerations for applicants and identify the types of surgical cases selected for submission in the evaluation videos.

Methods: The scoring rates for each item were examined based on the evaluation of 33 cases for which video assessment was performed using the 2021 technical certification scores for video screening. Additionally, factors such as the maximum diameter, weight, and protrusion rate of myomas, which are surgical indications, as well as operation time and irrigation fluid balance, were analyzed.

Results: The 2023 final passing rate of qualified gynecologists of endoscopy (hysteroscopy) was 63.6％. In the successful candidate group, the scoring rate for each sub-item was above 60％ for all items. In contrast, in the unsuccessful candidate group, the scoring rate was below 60％ for 10 out of 17 items and was as low as 20％ for two items. Regarding the relationship among the protrusion rate, maximum myoma diameter, and success rate, the success rate was 60％ (6/10) in the easiest group (protrusion rate of ≥70％ and maximum diameter of <2.47 cm) and 85.7％ (6/7) in the most difficult group (protrusion rate of <70％ and maximum diameter of ≥2.47 cm). The intergroup difference was not significant (p=0.252). The difference in the irrigation fluid balance tended to increase with longer operation times. In all cases in which hypotonic solutions were used, the difference was ≤500 ml, while in cases in which normal saline was used, six cases showed a difference of >500 ml.

Conclusion: To become a qualified gynecologist of endoscopy (hysteroscopy), it is crucial to ensure a clear and safe surgical field and perform incision and dissection in the correct anatomical layer without causing unnecessary damage to the normal mucosa.