Resident gynecologists and total hysterectomy.
We examined the specific number of surgeries necessary for a three-year obstetrics and gynecology resident to acquire proficiency in two types of hysterectomies. Improvement in the technical skills of the residents was assessed using surgical time and blood loss, and resected tumor weight was chosen as the factor representing the difficulty of the surgery. Regarding abdominal total hysterectomy (ATH), early residents (less than 25 ATH experience) performed relatively easier surgeries, and improvement in technical skill was manifested as reduced blood loss by mid residents (25 to 49 ATH) and as shortened surgical time by later residents (75 or more ATH). Regarding vaginal total hysterectomy (VTH), blood loss for earlier residents (less than 15 VTH) was greater than that for the staff, and there was a significant difference between staff surgical time and that for each resident group. These data suggest that performing more than 75 ATH during the residency period of three years is adequate to establish proficiency in this type of surgery, but that the execution of 25 VTH is insufficient and that residents require more training to learn VTH.
Yaegashi
N
N
Department of Obstetrics and Gynecology, Hachinohe City Hospital, Japan.
Kuramoto
M
M
Nakayama
C
C
Nakano
M
M
Yajima
A
A
D016063:Blood Loss, Surgical; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D007045:Hysterectomy, Vaginal / Q000009:adverse effects; D007396:Internship and Residency; D009929:Organ Size; D013997:Time Factors; D014594:Uterine Neoplasms / Q000601:surgery