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Original Articles
The Impact of Systematic Laparoscopic Skills and Suture Training on Laparoscopic Hysterectomy Outcomes in a Brazilian Teaching Hospital
- Anna Luiza Lobão Gonçalves
, - Helizabet Abdala Ayroza-Ribeiro,
- Raquel Ferreira Lima,
- Aline Estefane Eras Yonamine,
- Fabio Ohara, [ ... ],
- Paulo Augusto Galvão Ayroza-Ribeiro
02-03-2019
Summary
Original ArticlesThe Impact of Systematic Laparoscopic Skills and Suture Training on Laparoscopic Hysterectomy Outcomes in a Brazilian Teaching Hospital
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(12):718-725
02-03-2019- Anna Luiza Lobão Gonçalves ,
- Helizabet Abdala Ayroza-Ribeiro,
- Raquel Ferreira Lima,
- Aline Estefane Eras Yonamine,
- Fabio Ohara,
- Paulo Augusto Galvão Ayroza-Ribeiro
Views162See moreAbstract
Objective
To evaluate the impact of systematic laparoscopic skills and suture training (SLSST) on the total laparoscopic hysterectomy intra- and postoperative outcomes in a Brazilian teaching hospital.
Methods
A cross-sectional observational study in which 244 charts of total laparoscopic hysterectomy (TLH) patients operated from 2008 to 2014 were reviewed. Patient-specific (age, parity, previous cesarean sections, abdominal surgeries and endometriosis) and surgery-related variables (hospital stay, operative time, uterine volume and operative complications) were analyzed in three different time-frame groups: 2008-09 (I-1) - TLHs performed by senior attending physicians; 2010-11 (I-2) - TLHs performed by residents before the implementation of the SLSST program; and 2012-14 (I-3) - TLHs performed by residents after the implementation of the SLSST program.
Results
A total of 244 TLH patients (mean age: 45.93 years) were included: 24 (I-1), 55 (I-2), and 165 (I-3). The main indication for TLH was uterine myoma (66.4%). Group I-3 presented a decrease in surgical time compared to group I-2 (p=0.010). Hospital stay longer than 2 days decreased in group I-3 compared to group I-2 (p=0.010). Although we observed decreased uterine volume (154.2 cm3) in group I-2 compared to group I-1 (217.8 cm3) (p=0.030), logistic regression did not find any association between uterine volume and surgical time (p=0.103).
Conclusion
The total operative time for laparoscopic hysterectomy was significantly shorter in the group of patients (I-3) operated after the systematic laparoscopic skills and suture training was introduced in our hospital.
Views162
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticlesThe Impact of Systematic Laparoscopic Skills and Suture Training on Laparoscopic Hysterectomy Outcomes in a Brazilian Teaching Hospital
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(12):718-725
02-03-2019- Anna Luiza Lobão Gonçalves ,
- Helizabet Abdala Ayroza-Ribeiro,
- Raquel Ferreira Lima,
- Aline Estefane Eras Yonamine,
- Fabio Ohara,
- Paulo Augusto Galvão Ayroza-Ribeiro
Views162See moreAbstract
Objective
To evaluate the impact of systematic laparoscopic skills and suture training (SLSST) on the total laparoscopic hysterectomy intra- and postoperative outcomes in a Brazilian teaching hospital.
Methods
A cross-sectional observational study in which 244 charts of total laparoscopic hysterectomy (TLH) patients operated from 2008 to 2014 were reviewed. Patient-specific (age, parity, previous cesarean sections, abdominal surgeries and endometriosis) and surgery-related variables (hospital stay, operative time, uterine volume and operative complications) were analyzed in three different time-frame groups: 2008-09 (I-1) - TLHs performed by senior attending physicians; 2010-11 (I-2) - TLHs performed by residents before the implementation of the SLSST program; and 2012-14 (I-3) - TLHs performed by residents after the implementation of the SLSST program.
Results
A total of 244 TLH patients (mean age: 45.93 years) were included: 24 (I-1), 55 (I-2), and 165 (I-3). The main indication for TLH was uterine myoma (66.4%). Group I-3 presented a decrease in surgical time compared to group I-2 (p=0.010). Hospital stay longer than 2 days decreased in group I-3 compared to group I-2 (p=0.010). Although we observed decreased uterine volume (154.2 cm3) in group I-2 compared to group I-1 (217.8 cm3) (p=0.030), logistic regression did not find any association between uterine volume and surgical time (p=0.103).
Conclusion
The total operative time for laparoscopic hysterectomy was significantly shorter in the group of patients (I-3) operated after the systematic laparoscopic skills and suture training was introduced in our hospital.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Anna Luiza Lobão Gonçalves
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Original Article
The Effect on Performance Time and Quality of the Knots after Mono or Bimanual Training of Laparoscopic Intracorporeal Knot Tying according to the Gladiator Rule Technique
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(5):266-274
05-01-2018
Summary
Original ArticleThe Effect on Performance Time and Quality of the Knots after Mono or Bimanual Training of Laparoscopic Intracorporeal Knot Tying according to the Gladiator Rule Technique
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(5):266-274
05-01-2018Views105Abstract
Objective
To assesswhether themonomanual or bimanual training of laparoscopic suture followingthe sametechniquemay interferewith theknots’ performancetimeand/or quality.
Methods
A prospective observational study involving 41 resident students of gynecology/ obstetrics and general surgery who attended a laparoscopic suture training for 2 days. The participants were divided into two groups. Group A performed the training using exclusively their dominant hand, and group B performed the training using both hands to tie the intracorporeal knot. All participants followed the same technique, called Romeo Gladiator Rule. At the end of the course, the participants were asked to perform three exercises to assess the time it took them to tie the knots, as well as the quality of the knots.
Results
A comparative analysis of the groups showed that there was no statistically significant difference (p = 0.334) between them regarding the length of time to tie one knot. However, when the time to tie 10 consecutive knots was compared, group A was faster than group B (p = 0.020). A comparison of the knot loosening average, in millimeters, revealed that the knots made by group B loosened less than those made by group A, but there was no statistically significant difference regarding the number of knots that became untied.
Conclusion
This study demonstrated that the knots from group B showed better quality than those from group A, with lower loosening measures and more strength necessary to untie the knots. The study also demonstrated that group A was faster than B when the time to tie ten consecutive knots was compared.
Key-words laparoscopic trainingsuture trainingSee moreViews105This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleThe Effect on Performance Time and Quality of the Knots after Mono or Bimanual Training of Laparoscopic Intracorporeal Knot Tying according to the Gladiator Rule Technique
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(5):266-274
05-01-2018Views105Abstract
Objective
To assesswhether themonomanual or bimanual training of laparoscopic suture followingthe sametechniquemay interferewith theknots’ performancetimeand/or quality.
Methods
A prospective observational study involving 41 resident students of gynecology/ obstetrics and general surgery who attended a laparoscopic suture training for 2 days. The participants were divided into two groups. Group A performed the training using exclusively their dominant hand, and group B performed the training using both hands to tie the intracorporeal knot. All participants followed the same technique, called Romeo Gladiator Rule. At the end of the course, the participants were asked to perform three exercises to assess the time it took them to tie the knots, as well as the quality of the knots.
Results
A comparative analysis of the groups showed that there was no statistically significant difference (p = 0.334) between them regarding the length of time to tie one knot. However, when the time to tie 10 consecutive knots was compared, group A was faster than group B (p = 0.020). A comparison of the knot loosening average, in millimeters, revealed that the knots made by group B loosened less than those made by group A, but there was no statistically significant difference regarding the number of knots that became untied.
Conclusion
This study demonstrated that the knots from group B showed better quality than those from group A, with lower loosening measures and more strength necessary to untie the knots. The study also demonstrated that group A was faster than B when the time to tie ten consecutive knots was compared.
Key-words laparoscopic trainingsuture trainingSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
suture training Archives - Revista Brasileira de Ginecologia e Obstetrícia
