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Learning Curve of Total Laparoscopic Hysterectomy for a Resident in a High-Volume Resident Training Setup

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Abstract

Study Objective

To evaluate the resident learning curve, demographic and comparative analysis of total laparoscopic hysterectomy.

Design

This retrospective observational study was conducted in a high-volume resident training setup.

Setting

Tertiary care center is used in the study.

Materials and Methods

Eight hundred and one total laparoscopic hysterectomy patients operated by the residents between July 2013 and June 2019 were evaluated with respect to the learning curve, duplication of the steps, the results in terms of intra- and postoperative complications and the time taken for the surgery. Surgeries were assigned as per the institutional inclusion criteria for the residents. The fellowship program enrolled six residents per year for training period of 1 year. The residents initially performed ten simple cases under the supervision of the director followed by ten cases which were performed independently, and based on their learning curve, they then performed advanced cases independently.

Results

TLH was successfully performed in all women by surgical residents in training. The surgical time was 61–120 min in majority (49.3%). 2.99% had intra-operative complications while 7.61% had postoperative complications which were identified and managed. All women recovered uneventfully.

Conclusion(s)

Dedicated teaching staff, uniform surgical protocols and high-volume centers contribute to the safety of TLH.

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Abbreviations

TLH:

Total laparoscopic hysterectomy

BMI:

Body mass index

LSCS:

Lower segment cesarean section

Fig:

Figure

LH:

Laparoscopic hysterectomy

LAVH:

Laparoscopic assisted vaginal hysterectomy

CO2:

Carbon dioxide

POD:

Postoperative day

LSCH:

Laparoscopic-assisted supracervical hysterectomy

N:

Number

PID:

Pelvic inflammatory disease

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Authors and Affiliations

  1. Galaxy Care Multispeciality Hospital, 25-A, Ayurveda Rasashala Premises, Karve Road, Opposite Garware College, Pune, Maharashtra, 411004, India

    Shailesh Puntambekar MS, Theertha Shetty MS, Seema Puntambekar MS, Arjun Goel MS, Mangesh Panse MD, Ravindra Sathe MS & Swapnil Shelke MS

Authors
  1. Shailesh Puntambekar MS
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  2. Theertha Shetty MS
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  3. Seema Puntambekar MS
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  4. Arjun Goel MS
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  5. Mangesh Panse MD
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  6. Ravindra Sathe MS
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  7. Swapnil Shelke MS
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Corresponding author

Correspondence to Theertha Shetty MS.

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The authors declare that they have no conflicts of interest and nothing to disclose.

Ethical Approval

The study was approved by the Institutional Ethics Committee. Institutional Ethical Clearance taken.

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Informed consent was obtained from all human participants.

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Shailesh Puntambekar, Specialist in the Department of Minimal Access Surgery; Theertha Shetty, Fellow in the Department of Minimal Access Surgery (Gynaecology); Seema Puntambekar, Specialist in the Department of Minimal Access Surgery; Arjun Goel, Fellow in the Department of Minimal Access Surgery; Mangesh Panse, Specialist in the Department of Minimal Access Surgery; Ravindra Sathe, Specialist in the Department of Minimal Access Surgery; Swapnil Shelke, Fellow in the Department of Minimal Access Surgery (Gynaecology).

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Puntambekar, S., Shetty, T., Puntambekar, S. et al. Learning Curve of Total Laparoscopic Hysterectomy for a Resident in a High-Volume Resident Training Setup. J Obstet Gynecol India 72 (Suppl 1), 267–273 (2022). https://doi.org/10.1007/s13224-021-01540-8

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  • DOI: https://doi.org/10.1007/s13224-021-01540-8

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