Fellowship learning curve associated with completing a robotic assisted total laparoscopic hysterectomy. Academic Article uri icon

Overview

abstract

  • OBJECTIVE: To describe the learning curve associated with training fellows in completing robotic assisted total laparoscopic hysterectomies. METHODS: All patients scheduled to undergo a robotic procedure at our institution from 5/15/07 to 5/22/12 were identified. Fellow participation per procedure was documented. The learning curve of fellows for the time to complete a hysterectomy (from initiation of developing the retroperitoneal space to the completion of the colpotomy) was analyzed. RESULTS: Of the 1754 planned robotic cases, 1626 were completed robotically and 128 were converted to laparotomy. Fifty-seven fellows participated in 99.7% of the cases. Eleven gynecologic oncology fellows completed at least 1 robotic assisted total laparoscopic hysterectomy. From 7/7/08 to 5/21/12, 981 hysterectomies were completed robotically, 254 of these (25.9%) by the 11 fellows. Prior to completing a hysterectomy, the median number of hysterectomies in which a fellow participated was 16 (range, 11-40). Median amount of time for a fellow to complete a hysterectomy decreased from 60 min in 2009 (N=27 cases) to 31 min in 2011 (N=148 cases). Based on the recorded completion times in which the 11 fellows completed a hysterectomy, it required ~33 cases per fellow to be able to perform the hysterectomy and overcome the learning curve. CONCLUSIONS: The learning curve associated with hysterectomy requires completion of ~33 cases by the fellow after an initial median experience of 16 cases. Our data suggest that a minimum of 50 total cases is required during fellowship to complete a robotic hysterectomy.

publication date

  • November 18, 2013

Research

keywords

  • Fellowships and Scholarships
  • Genital Neoplasms, Female
  • Hysterectomy
  • Laparoscopy
  • Learning Curve
  • Robotics

Identity

Scopus Document Identifier

  • 84892803303

Digital Object Identifier (DOI)

  • 10.1016/j.ygyno.2013.11.017

PubMed ID

  • 24262878

Additional Document Info

volume

  • 132

issue

  • 1