The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on falloposcopy with coaxial catheter.
As part of the NICE's work programme, the current guidance was considered for review but did not meet the review criteria as set out in the IP process guide. The guidance below therefore remains current.
This procedure is used to investigate and treat subfertility in women.
One in six couples require investigation or treatment of subfertility. Conventional investigation of subfertility in women often includes an examination of the fallopian tubes using hysterosalpingography (an X-ray test) or laparoscopy with dye injection to check the patency of the Fallopian tubes. More rarely salpingoscopy is performed. This is the inspection of the inside of the fallopian tubes from the outer fimbrial end, at laparoscopy or laparotomy.
Falloposcopy is a technique that allows direct inspection of the inside of the fallopian tubes. The fallopian tubes are approached through the cervix and uterus.
There are two main types of falloposcope: coaxial and linear everting catheter. The coaxial technique involves inserting a narrow catheter over a guidewire through the cervix and uterine cavity into the fallopian tubes. The surgeon then passes a flexible endoscope through the catheter. Coaxial falloposcopy is usually carried out under local anaesthetic and mild sedation.
This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.