title: Learning curve and surgical outcome for single-port access total laparoscopic hysterectomy in 100 consecutive cases.
abstract: OBJECTIVE
  To define the learning curve for single-port access (SPA) total laparoscopic hysterectomy (TLH) and evaluate the surgical outcomes.
  
  
  METHODS
  Patient demographics and segmental operating times of all 100 patients who underwent SPA-TLH by a single surgeon were analyzed. Patients were arranged in order based on surgery date.
  
  
  RESULTS
  100 patients underwent SPA-TLH. There was no conversion to conventional laparoscopy or laparotomy. The median time until the removal of a specimen (T(R)) was 45 min and the median time for closure of the vaginal cuff (T(C)) was 18 min. The median total operating time from skin opening to closure (T(O)) was 80 min. T(R), T(C), and T(O) decreased significantly over the study period. The T(C) decreased significantly from the first 20 cases to the next 20 (p = 0.028) and the T(O) from the second 20 cases to the next 20 (p = 0.029).
  
  
  CONCLUSIONS
  Proficiency for SPA-TLH was achieved after 40 cases. Operating time and postoperative hemoglobin drop decreased with experience, without increasing complication.
authors: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, South Korea.
authors: Jiheum
authors: J
authors: Paek
authors: Sang-Wun
authors: SW
authors: Kim
authors: San-Hui
authors: SH
authors: Lee
authors: Maria
authors: M
authors: Lee
authors: Ga-Won
authors: GW
authors: Yim
authors: Eun-Ji
authors: EJ
authors: Nam
authors: Young-Tae
authors: YT
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D059032:Learning Curve; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins