Implementation of laparoscopic sacrocolpopexy--a single centre's experience.
OBJECTIVE
The aim of this study was to describe the learning curve of a single surgeon to achieve the ability to perform a complication-free and anatomically successful laparoscopic sacrocolpopexy (LSC).


METHODS
All patients, from the first LSC onwards (1996) were included. Outcome measures were operation time, number of laparotomies, complications and anatomical failures within 3 months. Learning curves were generated using moving average method (MOA) and cumulative sum (CUSUM) analysis to assess changes in respectively operation time and failures (laparotomy, complication or anatomical failure).


RESULTS
Of the 206 patients, 83% were completed by laparoscopy. The intra-operative and major respectively minor post-operative complication rates were 2.4% (n = 5), 4.4% (n = 9) and 12.6% (n = 26). CUSUM analysis showed adequate learning after 60 cases. MOA showed that operation time declined rapidly during the first 30 procedures reaching a steady state (175 min) after 90 cases. Complications remained unchanged throughout the series.


CONCLUSIONS
LSC was associated with a low complication rate but a long learning curve.
Claerhout
Filip
F
Pelvic Floor Unit, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, Belgium.
Roovers
Jan Paul
JP
Lewi
Paul
P
Verguts
Jasper
J
De Ridder
Dirk
D
Deprest
Jan
J
D000368:Aged; D002983:Clinical Competence; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D053825:Suburethral Slings; D014596:Uterine Prolapse / Q000601:surgery