Implementation of laparoscopic sacrocolpopexy—a single centre’s experience
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Abstract
Introduction and hypothesis
The aim of this study was to describe the learning curve of a single surgeon to achieve the ability to perform a complication-free and anatomically successful laparoscopic sacrocolpopexy (LSC).
Methods
All patients, from the first LSC onwards (1996) were included. Outcome measures were operation time, number of laparotomies, complications and anatomical failures within 3 months. Learning curves were generated using moving average method (MOA) and cumulative sum (CUSUM) analysis to assess changes in respectively operation time and failures (laparotomy, complication or anatomical failure).
Results
Of the 206 patients, 83% were completed by laparoscopy. The intra-operative and major respectively minor post-operative complication rates were 2.4% (n = 5), 4.4% (n = 9) and 12.6% (n = 26). CUSUM analysis showed adequate learning after 60 cases. MOA showed that operation time declined rapidly during the first 30 procedures reaching a steady state (175 min) after 90 cases. Complications remained unchanged throughout the series.
Conclusions
LSC was associated with a low complication rate but a long learning curve.
Keywords
CUSUM Feasibility Learning curve Laparoscopy Prolapse SacrocolpopexyAbbreviations
- BMI
Body mass index
- CUSUM
Cumulative sum
- LSC
Laparoscopic sacrocolpopexy
- MOA
Moving average method
- POPQ
Pelvic organ prolapse quantification
Notes
Acknowledgment
We are indebted to Dr. Pino Cusumano for training us with this procedure in the early days.
Conflicts of interest
None
References
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