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Related Experiment Video

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A Novel, Structured Fellow Training Pathway for Robotic-Assisted Sacrocolpopexy.

Tatiana Catanzarite1, Jasmine Tan-Kim1, John N Nguyen2

  • 1Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Southern California Permanente Medical Group, San Diego, CA.

The Permanente Journal
|March 29, 2022
PubMed
Summary

Fellows can safely perform robotic-assisted sacrocolpopexy (RASC) with similar operative times and complication rates compared to attendings. This novel training pathway supports quality and safety in surgical education.

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Area of Science:

  • Urology
  • Gynecology
  • Surgical Education

Background:

  • Robotic-assisted sacrocolpopexy (RASC) is a complex procedure for pelvic organ prolapse.
  • Fellowship training pathways are crucial for developing surgical expertise.
  • Evaluating fellow involvement in RASC is important for assessing training efficacy and patient safety.

Purpose of the Study:

  • To develop and evaluate a novel fellow education pathway for RASC.
  • To compare operative times for RASC performed by attendings versus fellows.
  • To compare complication and readmission rates based on fellow involvement in RASC.

Main Methods:

  • A retrospective review of 178 RASC procedures performed between 2012 and 2018.
  • Data collection included total procedure time, step-specific times, and concomitant procedures.
  • Statistical analysis used independent samples t-tests, ANOVA, chi-squared, and Fisher's exact tests.

Main Results:

  • Fellows were involved in 42.7% of RASC procedures.
  • Total operative times and most step-specific times were similar between attending and fellow-performed RASC.
  • The 'docking' step was significantly faster when performed by fellows (7.2 minutes) compared to attendings (9.9 minutes).
  • Complication and readmission rates were comparable between groups.

Conclusions:

  • A structured fellowship training program for RASC is safe and effective.
  • Fellow involvement in RASC does not adversely affect operative times or patient safety.
  • This training pathway supports quality and safety in a teaching environment.