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Ultrasound I: Abdominal Ultrasonography01:20

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Introduction:
Abdominal ultrasonography, commonly known as abdominal ultrasound, is a vital, non-invasive medical imaging technique widely used in healthcare.
Procedure:
This diagnostic tool allows the clinician to visually inspect internal structures within the abdomen, including vital organs such as the liver, gallbladder, pancreas, kidneys, and spleen.
The abdominal ultrasound process begins with applying a special gel to the patient's skin over the abdomen. This gel enhances the...
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Complex obstetrical surgery: building a team and defining roles.

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Rising placenta accreta spectrum cases reveal a surgical skills gap. This commentary proposes an obstetrician-led team approach to complex obstetrical surgery, matching provider expertise with case complexity.

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Area of Science:

  • Obstetrics and Gynecology
  • Surgical Education

Background:

  • Increasing incidence of placenta accreta spectrum (PAS) cases.
  • Observed decline in advanced surgical skills among obstetrician-gynecologists, especially recent graduates.
  • Prevalence of referring complex cesarean deliveries and obstetrical hysterectomies to subspecialists like gynecologic oncologists.

Purpose of the Study:

  • To propose a structured process for managing complex obstetrical surgeries.
  • To delineate the roles and appropriate involvement levels of key personnel within obstetrics and gynecology departments.
  • To match surgical expertise with the complexity of cesarean deliveries.

Main Methods:

  • Identification of key personnel within obstetrics and gynecology departments.
  • Delineation of provider roles and responsibilities based on surgical skill levels.
  • Description of expected surgical skills for each provider level.
  • Formation of an obstetrician-led complex obstetrical surgery team.

Main Results:

  • A framework for an obstetrician-led complex obstetrical surgery team.
  • A process to match cesarean delivery complexity with specific surgical expertise.
  • Potential to return complex cases to obstetricians, reducing subspecialist burden.

Conclusions:

  • Implementing a structured team approach can enhance management of complex obstetrical surgeries.
  • Matching surgical skills to case complexity improves patient care and optimizes resource utilization.
  • Empowering obstetricians to manage more complex cases reduces reliance on gynecologic oncology subspecialists.