For low risk procedures most patients prefer that the procedure be performed in office than than a hospital setting for several reasons; 1. The office is more comfortable for most patients because it is familiar and because they don’t have the increased anxiety associated with going to the hospital  2. Most patients require minimal pain relief  3. The patients are able to leave for home sooner because they haven’t had deep anesthesia.  Two procedures that are well adapted to the office that I am quite comfortable performing are 1. Essure for permanent contraception and 2.Thermachoice for controlling heavy vaginal bleeding thus avoiding a hysterectomy.