title: Learning curves of a resident surgeon performing transobturator tape procedures for stress urinary incontinence.
abstract: OBJECTIVE
  To evaluate the number of procedures necessary for an untrained resident surgeon to learn transobturator tension-free vaginal tape (TVT-O) procedures for treatment of stress urinary incontinence (SUI).
  
  
  METHODS
  A prospective study was performed among patients aged 18-75 years who underwent TVT-O procedures at a center in Rome, Italy, between March 2, 2009, and November 30, 2012. The TVT-O procedure was performed by a right-handed resident surgeon working under the supervision of an expert surgeon. Total and partial operative times were recorded.
  
  
  RESULTS
  Among 18 patients included in analysis, the mean operative time was 22.2minutes (range 7-44). All total operative times fell within the confidence interval after the 10th procedure, with a difference between the mean times recorded in the first nine and the last eight procedures (29.5 vs 13.1minutes; P<0.001). The resident surgeon required nine procedures to learn right tunneling and 13 to learn left tunneling.
  
  
  CONCLUSIONS
  Ten procedures were required for a resident surgeon to learn TVT-O procedures for SUI.
authors.affiliation: Department of Obstetrics and Gynaecology, Magna Graecia University of Catanzaro, Catanzaro, Italy; Department of Obstetrics and Gynecology, Campus Bio-Medico University of Rome, Rome, Italy. Electronic address: r.montera@unicampus.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Montera
authors.affiliation: Department of Obstetrics and Gynecology, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Plotti
authors.affiliation: Department of Obstetrics and Gynecology, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Ricciardi
authors.affiliation: Department of Obstetrics and Gynecology, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Miranda
authors.affiliation: Department of Obstetrics and Gynaecology, Magna Graecia University of Catanzaro, Catanzaro, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Venturella
authors.affiliation: Department of Obstetrics and Gynaecology, Magna Graecia University of Catanzaro, Catanzaro, Italy.
authors.forename: Fulvio
authors.initials: F
authors.lastname: Zullo
authors.affiliation: Department of Obstetrics and Gynecology, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Angioli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007558:Italy; D059032:Learning Curve; D008875:Middle Aged; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures; D055815:Young Adult
keywords: Learning curve; Midurethral sling; Resident surgeon; Sling placement; Stress urinary incontinence; Transobturator tape; Transobturator tension-free vaginal tape