Journal List > Korean J Obstet Gynecol > v.53(10) > 1006488

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Oh, Hwang, Yi, Song, Lee, Hur, and Shin: Learning curves of total laparoscopic hysterectomies in three gynecologists
Original Article
Korean Journal of Obstetrics and Gynecology

Korean Journal of Obstetrics and Gynecology 2010; 53(10): 927-933.

Published online: 31 October 2010

DOI: https://doi.org/10.5468/kjog.2010.53.10.927

Learning curves of total laparoscopic hysterectomies in three gynecologists

Yoon Kyung Oh, M.D., Hyo Soon Hwang, M.D., Kyung Wook Yi, M.D., Ph.D., Seung-Hun Song, M.D., Ph.D., Jae Kwan Lee, M.D., Ph.D., Jun-Young Hur, M.D., Ph.D., Jung-Ho Shin, M.D., Ph.D.

Department of Obstetrics and Gynecology, Guro Hospital, Korea University College of Medicine, Seoul, Korea.

Corresponding author (shinjh@korea.ac.kr)

Received 11 May 2010       Accepted 12 July 2010

Copyright © 2010 Korean Society of Obstetrics and Gynecology

Abstract

Objective

Total laparoscopic hysterectomy (TLH) is becoming more commonly used as an alternative to traditional abdominal hysterectomy and Analyzing the turning point of a learning curve can be useful in planning training programs. This study was to define the average turning point of a learning curve of TLH by comparing three separate gynecologists in one institute.

Methods

Retrospective analysis of the first 140 consecutive cases of TLH performed by three separate gynecologists A, B, and C. Patients of each gynecologist were divided into 7 equal groups of 20 operations classed chronologically. Patient's age, uterus weight, operation time and pre-post operative hemoglobin difference of the three gynecologists were compared. Operation time and pre-post operative hemoglobin difference were evaluated to build learning curves for each gynecologist.

Results

Learning curve built by operation time showed turning point after 80~100 cases in all three gynecologists. Learning curve built by pre-post operative hemoglobin difference did not show a decreasing pattern. There were no statistical differences in patient's age and pre-post operative hemoglobin difference between the three gynecologists. However, mean uterine weight of gynecologist C was significantly lighter than that of gynecologist A and B. Operation time was significantly longer in cases by gynecologist C than in cases by A and B.

Conclusion

At least 80~100 cases of experience in TLH is needed for a gynecologist to reach the turning point of the learning curve. This result can be used as a guide to the training program of TLH.

Keywords: Total laparoscopic hysterectomy, Learning curve, Turning point, Operating time, Hemoglobin difference

Figures and Tables

Fig. 1
Percentage of 420 operations according to diagnosis. A: adenomyosis, AM: adenomyosis and myoma, M: myoma, C: cervical disease, E: endometrial disease, O: ovary disease, P: PID.
kjog-53-927-g001
Fig. 2
Learning curves of Operation time in gynecologists A, B, and C. (A) Turning point is observed after 80 cases in gynecologist A. (B) Turning point is observed after 80 cases in gynecologist B. (C) Turning point is observed after 100 cases in gynecologist C.
kjog-53-927-g002
Table 1
Characteristics of patients operated by gynecologists A, B, and C
kjog-53-927-i001

SD: standard deviation.

*ANOVA.

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