Ignorance of electrosurgery among obstetricians and gynaecologists

The purpose of this study was to assess the level of skill of laparoscopic surgeons in electrosurgery.

Subjects were asked to complete a practical diathermy station and a written test of electrosurgical knowledge.

Tests were held in teaching and non-teaching hospitals.

Twenty specialists in obstetrics and gynaecology were randomly selected and tested on the Monash University gynaecological laparoscopic pelvi-trainer. Twelve candidates were consultants with 9-28 years of practice in operative laparoscopy, and 8 were registrars with up to six years of practice in operative laparoscopy. Seven consultants and one registrar were from rural Australia, and three consultants were from New Zealand.

Candidates were marked with checklist criteria resulting in a pass/fail score, as well as a weighted scoring system. We retested 11 candidates one year later with the same stations.

No improvement in electrosurgery skill in one year of obstetric and gynaecological practice.

No candidate successfully completed the written electrosurgery station in the initial test. A slight improvement in the pass rate to 18% was observed in the second test. The pass rate of the diathermy station dropped from 50% to 36% in the second test.

The study found ignorance of electrosurgery/diathermy among gynaecological surgeons. One year later, skills were no better.