Trends in Reported Resident Surgical Experience in Hysterectomy

Washburn, Erin E.; Cohen, Sarah L.; Manoucheri, E.; Zurawin, Robert K.; Einarsson, Jon I.

doi:10.1016/j.jmig.2014.05.005

Cited by 32 publications

(13 citation statements)

References 17 publications

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“…An interesting implication of the changing rates in route of hysterectomy is how this will affect future Ob/Gyn resident training. From 2003 to 2011, the American Council of Graduate Medical Education (ACGME) reported a decline in the mean number of abdominal and vaginal hysterectomies per resident, by 27.4% and 43%, respectively [ 15 , 16 ]. This trend is consistent with the data from the community hospital, where a decline in both vaginal and abdominal hysterectomies was observed.…”

Section: Discussionmentioning

confidence: 99%

Trends in Route of Hysterectomy after the Implementation of a Comprehensive Robotic Training Program

Papalekas

Fisher

2018

Minimally Invasive Surgery

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Objective To evaluate trends in surgical approach for hysterectomy following the introduction and implementation of a comprehensive robotic surgery program. Methods A retrospective review of all hysterectomies done at two institutions, a community hospital and a suburban, tertiary-care teaching hospital, in the same health system over a five-year period, January 2010 through December 2014. A robotic surgery training program was implemented during the first year of the study and trends in route of hysterectomy were evaluated in the subsequent years. Results A total of 5175 patients undergoing hysterectomy, for both benign and malignant indications, were included in the study. There was a significant decrease in the percent of cases performed through an abdominal approach at both the community and teaching hospitals (19.3% decline at each institution). There was an inversely related significant increase in the percent of robotic procedures at both the community and teaching hospitals (44.5% and 17%, respectively). A decrease in number of cases performed vaginally over this period was only noted in the community hospital site (25.2% decrease), and there was a slightly higher rate of vaginal hysterectomies at the teaching hospital over this study period (21.9% in 2010, 24.1% in 2014). Conclusion The decrease in number of abdominal and laparoscopic hysterectomies and increase in number of robotic hysterectomies that was seen are consistent with national trends. The initiation of a robotic training program did not prevent the proliferation of use of the robot but did aim to ensure proficiency on the robot prior to gaining privileges for patient use. This type of comprehensive training and monitoring program could be applied to future technologic advances to ensure a standard level of surgical proficiency. Trends in route of hysterectomy are clearly multifactorial and involve patient, provider, and location-specific factors that are likely to continue to change.

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Section: Discussionmentioning

confidence: 99%

Trends in Route of Hysterectomy after the Implementation of a Comprehensive Robotic Training Program

Papalekas

Fisher

2018

Minimally Invasive Surgery

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“…By practicing in a simulation lab, residents can improve their psychomotor and cognitive skills in a riskfree setting (3)(4)(5)(6). The benefit of simulator-based training has been increasingly evident since total laparoscopy-assisted hysterectomy (TLH) & robot-assisted hysterectomy (RAH) cases accounted for more than 30% of the total hysterectomies in the United States (7). Hysterectomy is the most commonly performed gynecological surgical procedure after cesarean section; all residents should master these techniques during resident training (8).…”

Section: Introductionmentioning

confidence: 99%

The impact of a simulation-based training lab on outcomes of hysterectomy

Asoğlu¹,

Achjian²,

Akbilgiç³

et al. 2016

J Turkish German Gynecol Assoc

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Results:The average estimated blood loss before and after simulation-based training was significantly different in TAH and RAH groups (317±170 mL versus 257±146 mL, p=0.003 and 154±107 mL versus 102±88 mL, p=0.004, respectively), but no difference was found for TLH and VH. The mean of length of hospital stay was significantly different before and after simulation-based training for each technique: 3.7±2.3 versus 2.9±2.2 days for TAH, 2.0±1.2 versus 1.3±0.9 days for VH, 2.4±1.3 versus 1.9±2.5 days for TLH, and 2.0±1.3 versus 1.4±1.7 days for RAH (p<0.01). Conclusion:Based on our data, simulator-based training may play an integrative role in developing the residents' surgical skills and thus improving the surgical outcomes of hysterectomy. (J Turk Ger Gynecol Assoc 2016; 17: 60-4)

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“…Second, developments in surgical technique and especially the emergence of laparoscopy for gynaecologic surgery may have contributed to reducing the practice and/or learning of laparotomic hysterectomies by obstetricians 19 , especially the youngest 20 .…”

Section: Discussionmentioning

confidence: 99%

Surgical management of postpartum haemorrhage: survey of French obstetricians

Bouet

Brun

Madar

et al. 2016

Sci Rep

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The aim of our study was to assess the theoretical and practical knowledge of French obstetricians about the surgical management of postpartum haemorrhage (PPH). Our study is a national anonymous self-administered survey. A total of 363 obstetricians responded to this questionnaire between December 2013 and April 2014. Questionnaire sent through email to all French obstetricians who are members of either of two federations of hospital-based obstetricians. Answers were collected until the end of June 2014. The main outcome measure was obstetricians’ level of mastery of each surgical technique. The results were analysed descriptively (proportions). Only the 286 questionnaires fully completed were analysed; the complete response rate was 23% (286/1246). In all, 33% (95/286) of the responding obstetricians reported that they had not mastered sufficiently or even at all the technique for bilateral ligation of the uterine arteries, 37% (105/286) for uterine compression suture, 62% (178/286) for ligation of the internal iliac arteries, and 47% (134/286) for emergency peripartum hysterectomy. In all, 18% (52/286) of respondents stated that they had not mastered any of these techniques. Our study shows that a worrisome number of French obstetricians reported insufficient mastery of the surgical techniques for PPH management.

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Trends in Reported Resident Surgical Experience in Hysterectomy

Cited by 32 publications

References 17 publications

Trends in Route of Hysterectomy after the Implementation of a Comprehensive Robotic Training Program

Trends in Route of Hysterectomy after the Implementation of a Comprehensive Robotic Training Program

The impact of a simulation-based training lab on outcomes of hysterectomy

Surgical management of postpartum haemorrhage: survey of French obstetricians

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