TITLE:
Usefulness of Detailed Analysis with Operative Procedure of Total Laparoscopic Hysterectomy (TLH) Done a Single Surgeon, to Master the Surgical Technique of TLH and Gain Higher Proficiency
AUTHORS:
Tsutomu Muramoto, Shin Takenaka, Ryo Koike, Megumi Sano, Kyosuke Kamijo
KEYWORDS:
Total Laparoscopic Hysterectomy, on the Job Training, Learning Curve, Surgical Technique of TLH
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.12 No.11,
November
18,
2022
ABSTRACT: Objective: To analyze the relationship between the
numbers of cases experienced and the operation time for a single surgeon
aiming to master the TLH surgical technique.
Material and Methods: Retrospective data analysis of women who underwent
TLH for benign diseases between April, 2014 and March, 2016 was conducted by a single surgeon in a single hospital (Showa University of
Fujigaoka Hospital). We divided the main procedures of the TLH operation into five sections, and measured the time
required for each section. These
cases were divided into three groups, group 1, 2, and 3. Results: There were 54 cases of TLH over two years for a single
surgeon, and 21 cases that included essential operative procedures were
divided into three groups of seven cases each. The average duration of the
surgery (min.) was 178.3 ± 48.2 in the group 1, 128.3 ± 15.6 in the group 2,
and 111.3 ± 15.9 in the group 3. A significant reduction in the required time
was observed between group 1, 2, and 3 groups. As the number of cases
increased, the operation time became statistically significantly shorter for
every section except B and D. The skill growth rate was different at each
section. Conclusion: For a single surgeon, as the number of surgical cases
increased, we recognized the increased skill with the procedure in every
section and the rate of skill growth differed for different sections. The
difference of growth rate for each section implied that the number of operative
cases required for a surgeon in each section was different.