Laparoscopic Pomeroy tubal ligation in a residency training program.
OBJECTIVE
To evaluate the efficacy of the laparoscopic Pomeroy method of tubal ligation as a teaching tool during the initial acquisition of advanced laparoscopic skills by 14 residents in a 28-person, 4-year program.


METHODS
A prospective, nonrandomized study.


METHODS
A metropolitan teaching hospital.


METHODS
Fifty-seven women who desired permanent sterilization, and 56 controls who underwent laparoscopic sterilization by standard coagulation. One refused entry and had standard sterilization by bipolar coagulation. In two women, both with several previous laparotomies, visualization of the pelvic organs was incomplete and the procedure was abandoned at the discretion of the surgeon. One had a minilaparotomy Pomeroy tubal ligation and the other was sterilized by standard two-puncture laparoscopic coagulation. One patient was excluded due to an incomplete data profile.


METHODS
Laparoscopic sterilizations using the Pomeroy technique and standard coagulation were performed by gynecology residents with an attending physician present. First-year residents performed 36 (68%) of the 53 procedures.


RESULTS
Operative times to teach this technique to house officers rotating on the gynecologic service were recorded by postgraduate year and stratified by the number of cases performed by each operator. The average operative times for residents in postgraduate years 1 through 4 were 18.6, 15.4, 21.7, and 14.8 minutes, respectively. These diminished with experience. A statistically longer time of 7.1 minutes was required to teach residents the Pomeroy technique compared with standard bipolar coagulation (p<0.0003).


CONCLUSIONS
Laparoscopic Pomeroy tubal ligation as a method to begin educating residents in advanced operative video-laparoscopy appears to have great potential.
Thomas
A G
AG
Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, New York 10029, USA.
Dottino
P
P
Brodman
M
M
Friedman
F
F
D005260:Female; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000379:methods; D011183:Postoperative Complications; D015397:Program Evaluation; D011446:Prospective Studies; D013246:Sterilization, Tubal / Q000379:methods*; D013663:Teaching / Q000379:methods; D016896:Treatment Outcome