Learning curves for laparoscopic hysterectomy after implementation of minimally invasive surgery. Issue 2 (August 2016)

• Record Type: Journal Article
• Authors: Mavrova, Russalina; Radosa, Julia C.; Wagenpfeil, Gudrun; Hamza, Amr; Solomayer, Erich-Franz; Juhasz-Böss, Ingolf
• Is Part Of: International journal of gynaecology and obstetrics. Volume 134:Issue 2(2016:Aug.)
• Page Start: 225
• Page End: 230
• Publication Date: 2016-08
• Subjects: Hysterectomy -- Laparoscopic supracervical hysterectomy -- Laparoscopy -- Learning curves -- Total laparoscopic hysterectomy; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1016/j.ijgo.2016.01.017
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Objective: To evaluate the learning process for total laparoscopic hysterectomy (TLH) and laparoscopic supracervical hysterectomy (LSH) for benign uterine pathologies among surgeons inexperienced in laparoscopy. Methods: A retrospective comparative study was conducted of all hysterectomies performed by four attending surgeons and three resident surgeons at a tertiary university center in Homburg/Saar, Germany. Laparoscopic procedures were assessed between October 1, 2009, and October 31, 2010 (period A); November 1, 2010, and March 31, 2012 (period B); and April 1, 2012, and June 30, 2013 (period C). Data were obtained by medical chart review. Results: Overall, 269 patients underwent TLH and 165 underwent LSH. Duration of surgery for all surgeons decreased from 136 ± 60 minutes in period A to 118 ± 44 minutes in period B ( P = 0.013), but increased to 122 ± 56 minutes in period C (A vs C: P = 0.067). Among attending surgeons, the duration of surgery seemed to decrease after 20 TLH procedures and after 10 LSH procedures. Among resident surgeons, duration decreased after 10 LSH procedures; no fall was apparent for TLH. Conclusion: Both TLH and LSH were readily adopted among a group of surgeons inexperienced in laparoscopy, although LSH might be easier to learn. Experienced surgeons have a steeper learning curve than do their inexperienced counterparts.