232: An Evaluation of The Resident Learning Curve in Performing Laparoscopic Supracervical Hysterectomies as Compared to Patient Outcomes—5-Year Experience

Abstract

Study ObjectiveTo compare surgical and postoperative results after laparoscopic supracervical hysterectomy between the first two cases and the last two cases performed by each senior resident.DesignRetrospective, case-control study (Canadian Task Force classification II-B).SettingUniversity hospital.PatientsTwo hundred six women undergoing laparoscopic supracervical hysterectomy.InterventionCharts were reviewed to determine length of surgery, operative and post-operative complications and other surgical values. A comparison was made between the first two and last two cases of 25 chief residents.Measurements and Main ResultsThe was no statistically significant difference between the first two and last two patients of each resident in terms of age, indication for surgery, uterine mass, ethnicity, body mass index, or parity. There was a significant decrease in the average time of the first two cases versus the last two cases: 201.4 min vs. 137.2 min (p>.001). There was no significant difference in blood loss, change in hematocrit, length of hospital stay, and surgical or postoperative complications.ConclusionWhile there is a steep learning curve for residents at our institution performing a laparoscopic supracervical hysterectomy, there does not appear to be any increased risks to the patient during the learning process. Since initially presenting his data in 2003, the senior residents are now getting twice the amount of exposure to this surgery. In addition, this data now includes residents who were exposed to this type of surgery as junior residents. While increased experience with the procedure results in a decrease in both the absolute average time of all cases and the difference in operative time from the initial two procedures to the last two procedures, this difference is still significant. Study ObjectiveTo compare surgical and postoperative results after laparoscopic supracervical hysterectomy between the first two cases and the last two cases performed by each senior resident. To compare surgical and postoperative results after laparoscopic supracervical hysterectomy between the first two cases and the last two cases performed by each senior resident. DesignRetrospective, case-control study (Canadian Task Force classification II-B). Retrospective, case-control study (Canadian Task Force classification II-B). SettingUniversity hospital. University hospital. PatientsTwo hundred six women undergoing laparoscopic supracervical hysterectomy. Two hundred six women undergoing laparoscopic supracervical hysterectomy. InterventionCharts were reviewed to determine length of surgery, operative and post-operative complications and other surgical values. A comparison was made between the first two and last two cases of 25 chief residents. Charts were reviewed to determine length of surgery, operative and post-operative complications and other surgical values. A comparison was made between the first two and last two cases of 25 chief residents. Measurements and Main ResultsThe was no statistically significant difference between the first two and last two patients of each resident in terms of age, indication for surgery, uterine mass, ethnicity, body mass index, or parity. There was a significant decrease in the average time of the first two cases versus the last two cases: 201.4 min vs. 137.2 min (p>.001). There was no significant difference in blood loss, change in hematocrit, length of hospital stay, and surgical or postoperative complications. The was no statistically significant difference between the first two and last two patients of each resident in terms of age, indication for surgery, uterine mass, ethnicity, body mass index, or parity. There was a significant decrease in the average time of the first two cases versus the last two cases: 201.4 min vs. 137.2 min (p>.001). There was no significant difference in blood loss, change in hematocrit, length of hospital stay, and surgical or postoperative complications. ConclusionWhile there is a steep learning curve for residents at our institution performing a laparoscopic supracervical hysterectomy, there does not appear to be any increased risks to the patient during the learning process. Since initially presenting his data in 2003, the senior residents are now getting twice the amount of exposure to this surgery. In addition, this data now includes residents who were exposed to this type of surgery as junior residents. While increased experience with the procedure results in a decrease in both the absolute average time of all cases and the difference in operative time from the initial two procedures to the last two procedures, this difference is still significant. While there is a steep learning curve for residents at our institution performing a laparoscopic supracervical hysterectomy, there does not appear to be any increased risks to the patient during the learning process. Since initially presenting his data in 2003, the senior residents are now getting twice the amount of exposure to this surgery. In addition, this data now includes residents who were exposed to this type of surgery as junior residents. While increased experience with the procedure results in a decrease in both the absolute average time of all cases and the difference in operative time from the initial two procedures to the last two procedures, this difference is still significant.