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- Title
HISTERECTOMÍA LAPAROSCÓPICA TOTAL, CURVA DE APRENDIZAJE: EXPERIENCIA DE CLÍNICA DEL PRADO, MEDELLÍN, COLOMBIA.
- Authors
Serna A., Eduardo; Riaño C., Giovanni; Almanza P., Luis; De Los Ríos P., José; Castañeda R., Juan; Calle G., Gustavo; Vásquez R., Ricardo; Arango M., Adriana; Mejía B., Ana
- Abstract
Objective: To compare the learning curve in total laparoscopic hysterectomy (HLT) from four gynecologists in the Clinica del Prado, Medell'n, Colombia. To determine the number of surgeries required to achieve an average surgical time of 90 minutes, to reduce laparoconversions to 3% or less and to reduce total compli- cations to less than 10%. Method: We performed a prospective cohort study including 626 patients operated by four gynecologists laparoscopist with similar technique and surgical equipment. We made four groups of patients according to the order in the cases of each one. Results: The mean operative time of 93 minutes is achieved with the first 50 HLT. Doing 50-100 HLT, laparoconversions rates low to 1.9%. The complication rate in the sum of first and second cohort is 19.4% and the total complication rate in third cohort is 8.7% (RR: 0.45; 95%CI 0.26-0.78) which remains in the desired limit (10%) in fourth cohort. Conclusions: HLT learning curve to achieve an average surgical time of 90 minutes is achieved with the first 50 hysterectomies. Despite the methodological limitations this study, shows that to achieve maximum expertise, it takes between 50-100 hysterectomies to achieve laparoconversions less than 3%, and between 100-150 hysterectomies to achieve total complications lower than 10%.
- Subjects
MEDELLIN (Colombia); COLOMBIA; LAPAROSCOPY; HYSTERECTOMY; SURGICAL complications; COHORT analysis; SURGICAL equipment
- Publication
Revista Chilena de Obstetricia y Ginecología, 2010, Vol 75, Issue 6, p367
- ISSN
0048-766X
- Publication type
Article
- DOI
10.4067/S0717-75262010000600005