Feasibility and safety of a surgical training program in total laparoscopic hysterectomy: Results of a pilot trial.
Aust N Z J Obstet Gynaecol
; 64(1): 48-54, 2024 Feb.
Article
en En
| MEDLINE
| ID: mdl-37486150
ABSTRACT
BACKGROUND:
It is widely accepted total laparoscopic hysterectomy (TLH) and vaginal hysterectomy are less invasive procedures compared to total abdominal hysterectomy (TAH). However, rates of TAH remain unreasonably high.AIM:
To pilot-test a model of training for practising obstetricians and gynaecologists (O&Gs) in TLH. MATERIALS ANDMETHODS:
Training of participating O&Gs was conducted across four hospitals in Queensland, Australia, while other O&Gs were observed as contemporary controls. Type of hysterectomy, details of the surgery, including adverse events, were collected from hospital medical records.RESULTS:
Eleven O&Gs completed the pre-intervention and intervention training periods, and nine completed the post-intervention follow-up. TLH rates increased from 24% prior to 75% during and 68% after intervention. Overall, the uptake rate of TLH showed a two-fold increase during the intervention period (2.08, 95% CI 1.16-8.56, P < 0.001) and a 12% increase was retained during the follow-up period (1.12, 95% CI 0.54-4.02, P = 0.427). Pre-intervention, across all sites, 24% of hysterectomies were performed via TAH by the participating specialist trainees, which decreased to 13% during the intervention and 14% during follow-up. The rate of adverse events decreased from 13.5% at pre-intervention, to 6.4% during and 4.2% post-intervention. By comparison, no change in surgical approach or rate of adverse events was observed in the control group.CONCLUSIONS:
The implementation of a formal and structured surgical training program teaching TLH resulted in important benefits to trainees, patients and society in the four trial hospitals.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Laparoscopía
Límite:
Female
/
Humans
Idioma:
En
Revista:
Aust N Z J Obstet Gynaecol
Año:
2024
Tipo del documento:
Article
País de afiliación:
Australia