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A retrospective study evaluating the impact of formal laparoscopic training on patient outcomes in a residency
R Wayne Whitted1, Paul A Pietro, George Martin
1University of Miami, Jackson Memorial Hospital, Miami, Florida, USA.
Study Objective:
To evaluate the impact of a formal laparoscopic training program on patient outcomes in an obstetrics and gynecology residency.
Design:
Retrospective cohort study (Canadian Task Force classification II-1).
Setting:
University-affiliated public hospital.
Intervention:
Comparison of nonlaparoscopy-trained group (A) with a formally trained group (B).
Subjects:
Three hundred sixty-eight women (group A) and 154 women (group B) undergoing operative laparoscopy.
Measurements And Main Results:
Beginning October 1, 1999, residents, regardless of postgraduate year status, participated in six 4-hour sessions/year in a committed laparoscopic training program consisting of didactics, bench exercises (designed to mimic laparoscopic gynecologic technical skills), instrumentation instruction, animate tissue model surgery, and supervised gynecologic operating experience. Two certified gynecology laparoscopists facilitated each training session, and gynecologists with various laparoscopic skill levels supervised patient surgeries. Operating room time, blood loss, hospital stay, and conversion to laparotomy were less for group B than for group A, but the groups did not differ in complication rates. Adhesions and bleeding were the main reasons for conversion to laparotomy.
Conclusion:
Formal laparoscopic training of gynecologic residents improved patient outcomes.
