Objective: To evaluate our first experience with 3mm hysteroscope. Design: Prospective study. Setting: Department of Obstetrics and Gynecology, 1st medical Faculty, Charles University, Prague. Methods: 105 hysteroscopic procedures in normal saline as distension fluid were performed between June and November 2001. We performed 60 (57.1%) diagnostic procedures and 45 (42.9%) minor surgical intrauterine interventions (mainly endometrial polyp < 2 cm ressection). We used Versascope (Gynecare, Johnson & Johnson) 1.9 mm optics with 3.2 mm expandable operative sheath. All diagnostic procedures were done by minimal invasive way – using vaginoscopic approach. Main part of procedures were performed without any anaesthesia. In case of operative intervention we used Versapoint bipolar electrodes in normal saline and active outflow. Results: The surgeon evaluated the intrauterine findings and the patient evaluated subjective comfort during the procedure (comfortable, uncomfortable, painful). No complications were registered during or post procedure. 83 (73%) women undergone diagnostic procedure described the procedure without discomfort, 22 (21%) women described a moderate discomfort with pressure in the lower abdomen (all undergone intrauterine surgical intervention). No patient described severe discomfort or wish to have general anesthesia. Conclusion: Miniaturized optical systems allows us to perform most cases of diagnostic and surgical intrauterine interventions (after proper patient selection) in an outpatient or office setting.

        Key words: hysteroscopy, vaporisation, transcervical surgery