Implementation of Laparoscopic Hysterectomy: Maintenance of Skills after a Mentorship Program

• Published in: Gynecologic and obstetric investigation Vol. 70; no. 3; pp. 173 - 178
• Main Authors: Twijnstra, A.R.H., Blikkendaal, M.D., Kolkman, W., Smeets, M.J.G.H., Rhemrev, J.P.T., Jansen, F.W.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.01.2010; S. Karger AG
• Subjects: Biological and medical sciences; Blood Loss, Surgical - statistics & numerical data; Clinical Competence; Digestive system. Abdomen; Education, Medical, Continuing - methods; Endoscopy; Female; Gynecology - education; Gynecology. Andrology. Obstetrics; Humans; Hysterectomy - education; Hysterectomy - methods; Investigative techniques, diagnostic techniques (general aspects); Laparoscopy - education; Laparoscopy - methods; Medical sciences; Mentors; Netherlands; Original Article; Postoperative Complications; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; Time and Motion Studies; Treatment Outcome; Netherlands; Patient safety; Advanced laparoscopic skills; Learning curve; Laparoscopic hysterectomy; Mentorship program; Human; Gynecology; Laparoscopy; Hysterectomy; Obstetrics; Implementation; Learning; Treatment; Surgery; Endoscopy; Safety
• ISSN: 0378-7346; 1423-002X
• DOI: 10.1159/000316266

Background: To evaluate the implementation and maintenance of advanced laparoscopic skills after a structured mentorship program in laparoscopic hysterectomy (LH). Methods: Cohort retrospective analysis of 104 successive LHs performed by two gynecologists during and after a mentorship program. LHs were compared for indication, patient characteristics and intraoperative characteristics. As a frame of reference, 94 LHs performed by the mentor were analyzed. Results: With regard to indication, blood loss and adverse outcomes, both trainees performed LHs during their mentorship program comparable with the LHs performed by the mentor. The difference in mean operating time between trainees and mentor was not clinically significant. Both trainees progressed along a learning curve, while operating time remained statistically constant and comparable to that of the mentor. After completing the mentorship program, both gynecologists maintained their acquired skills as blood loss, adverse outcome rates and operating time were comparable with the results during their traineeship. Conclusion: A mentorship program is an effective and durable tool for implementing a new surgical procedure in a teaching hospital with respect to patient safety aspects, as indications, operating time and adverse outcome rates are comparable to those of the mentor in his own hospital during and after completing the mentorship program.