title: Implementation of laparoscopic hysterectomy: maintenance of skills after a mentorship program.
abstract: BACKGROUND
  To evaluate the implementation and maintenance of advanced laparoscopic skills after a structured mentorship program in laparoscopic hysterectomy (LH).
  
  
  METHODS
  Cohort retrospective analysis of 104 successive LHs performed by two gynecologists during and after a mentorship program. LHs were compared for indication, patient characteristics and intraoperative characteristics. As a frame of reference, 94 LHs performed by the mentor were analyzed.
  
  
  RESULTS
  With regard to indication, blood loss and adverse outcomes, both trainees performed LHs during their mentorship program comparable with the LHs performed by the mentor. The difference in mean operating time between trainees and mentor was not clinically significant. Both trainees progressed along a learning curve, while operating time remained statistically constant and comparable to that of the mentor. After completing the mentorship program, both gynecologists maintained their acquired skills as blood loss, adverse outcome rates and operating time were comparable with the results during their traineeship.
  
  
  CONCLUSIONS
  A mentorship program is an effective and durable tool for implementing a new surgical procedure in a teaching hospital with respect to patient safety aspects, as indications, operating time and adverse outcome rates are comparable to those of the mentor in his own hospital during and after completing the mentorship program.
authors.affiliation: Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: A R H
authors.initials: AR
authors.lastname: Twijnstra
authors.forename: M D
authors.initials: MD
authors.lastname: Blikkendaal
authors.forename: W
authors.initials: W
authors.lastname: Kolkman
authors.forename: M J G H
authors.initials: MJ
authors.lastname: Smeets
authors.forename: J P T
authors.initials: JP
authors.lastname: Rhemrev
authors.forename: F W
authors.initials: FW
authors.lastname: Jansen
mesh_terms: D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000379:methods*; D005260:Female; D006176:Gynecology / Q000193:education*; D006801:Humans; D007044:Hysterectomy / Q000193:education* / Q000379:methods; D010535:Laparoscopy / Q000193:education* / Q000379:methods; D008611:Mentors; D009426:Netherlands; D011183:Postoperative Complications; D012189:Retrospective Studies; D013996:Time and Motion Studies; D016896:Treatment Outcome