Use of the Laparoscopic Pomeroy Tubal Ligation in a Residency Training Program
To evaluate the efficacy of the laparoscopic Pomeroy method of tubal ligation as a method for the initial acquisition of advanced laparoscopic skills, a y prospective, non-randomized study was done on 57 consecutive patients undergoing permanent sterilization using the Pomeroy technique involving videolaparoscopy, a three puncture approach, and plain catgut endoloops. Fifty-three of 56 patients completed the study. Two patients with previous multiple Cesarean sections required minilaparotomies and one patient's hospital data could not be located. Fourteen residents in a 28 person program were evaluated; 5 were first year residents, 2 were second year, 3 were third year, and 4 were fourth year. The average operative time for the PGY-1, PGY-2, PGY3 and PGY4 residents were 18.6, 15.4, 21.7, and 14.8 minutes respectively. No significant difference in operating time between residents within years (p=.54) or at differing PGY levels (p=.64) were noted. The time required to do each subsequent case diminished with experience. There were two minor complications. We conclude that the application of the laparoscopic Pomeroy tubal ligation as a method to begin educating residents in advanced operative video laparoscopy has great potential.
Thomas
AG
Department of Obstetrics and Gynecology, Mt. Sinai School of Medicine, One Gustave L. Levy Place, Box 1170, New York, NY 10029.