Increasing the Technicity Index to 92% in a Community Hospital: A 5-Year Retrospective Review

Area of Science:

• Gynecologic surgery
• Surgical outcomes research
• Minimally invasive procedures

Background:

• Hysterectomy is a common gynecologic procedure.
• Minimally invasive surgery (MIS) offers potential benefits over open approaches.
• Tracking surgical trends is crucial for quality improvement.

Purpose of the Study:

• To analyze trends in hysterectomy routes at Langley Memorial Hospital (LMH) over five years.
• To explore associations between patient characteristics and surgical approach.
• To evaluate surgical outcomes based on hysterectomy approach using the technicity index (TI).

Main Methods:

• Retrospective descriptive study of 706 women undergoing hysterectomy at LMH (2012-2016).
• Analysis of patient characteristics and surgical outcomes by hysterectomy route.
• Calculation of annual institutional and overall rates of hysterectomy by type.

Main Results:

• The TI increased from 67% to 92% between 2012 and 2016.
• Total laparoscopic hysterectomy proportion rose from 37% to 78%.
• MIS was linked to reduced blood loss and shorter hospital stays without increased surgical time.

Conclusions:

• LMH achieved a high TI, potentially among the highest in Canada.
• Factors contributing to success include experienced surgeons, mentorship, and consistent OR setup.
• High TI is achievable in community settings without compromising safety or efficiency.