Yoko Tsuzuki1,2, Takumi Hirata3, Shinya Tsuzuki4, Shinichiro Wada5, Akiko Tamakoshi3. 1. Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, 1-40, 1-jou, 12-choume, Maeda, Teine-ku, Sapporo city, Hokkaido, 006-8555, Japan. tsuzuki-yo@keijinkai.or.jp. 2. Department of Public Health, Hokkaido University Faculty and Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo city, Hokkaido, 060-8638, Japan. tsuzuki-yo@keijinkai.or.jp. 3. Department of Public Health, Hokkaido University Faculty and Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo city, Hokkaido, 060-8638, Japan. 4. Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan. 5. Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, 1-40, 1-jou, 12-choume, Maeda, Teine-ku, Sapporo city, Hokkaido, 006-8555, Japan.
Abstract
PURPOSE: This study sought to explore whether the experience level of the first assistant surgeon influences perioperative organ injuries (ureteral, bladder, and intestinal injuries) in patients undergoing total laparoscopic hysterectomy (TLH) for benign diseases. We defined an experienced surgeon as a surgeon certified by the Skill Qualification Committee of the Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy or a surgeon with equivalent surgical skills. METHODS: We reviewed our surgical registry database of TLH for benign indications between 2014 and 2020 and only selected cases performed by an experienced primary surgeon. Patients were divided into two groups based on the experience level of the first assistant. Inverse probability of treatment weighting by propensity score, which was adjusted for patient and procedure characteristics, was used to examine differences in perioperative organ injuries according to the experience level of the first assistant. RESULTS: Among 1682 patients who underwent TLH, 18 organ injuries were found (0.83%). In the propensity score inverse probability of treatment weighting models, less experience of the first assistant had no significant impact on the occurrence of perioperative organ injuries (p = 0.348). CONCLUSION: In TLH for benign indications at our hospital, given an experienced primary surgeon, the inclusion of a less experienced first assistant does not negatively affect the occurrence of perioperative organ injuries.
PURPOSE: This study sought to explore whether the experience level of the first assistant surgeon influences perioperative organ injuries (ureteral, bladder, and intestinal injuries) in patients undergoing total laparoscopic hysterectomy (TLH) for benign diseases. We defined an experienced surgeon as a surgeon certified by the Skill Qualification Committee of the Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy or a surgeon with equivalent surgical skills. METHODS: We reviewed our surgical registry database of TLH for benign indications between 2014 and 2020 and only selected cases performed by an experienced primary surgeon. Patients were divided into two groups based on the experience level of the first assistant. Inverse probability of treatment weighting by propensity score, which was adjusted for patient and procedure characteristics, was used to examine differences in perioperative organ injuries according to the experience level of the first assistant. RESULTS: Among 1682 patients who underwent TLH, 18 organ injuries were found (0.83%). In the propensity score inverse probability of treatment weighting models, less experience of the first assistant had no significant impact on the occurrence of perioperative organ injuries (p = 0.348). CONCLUSION: In TLH for benign indications at our hospital, given an experienced primary surgeon, the inclusion of a less experienced first assistant does not negatively affect the occurrence of perioperative organ injuries.
Authors: Benjamin B Albright; Tilman Witte; Alena N Tofte; Jeremy Chou; Jonathan D Black; Vrunda B Desai; Elisabeth A Erekson Journal: J Minim Invasive Gynecol Date: 2015-08-10 Impact factor: 4.137
Authors: Johanna W M Aarts; Theodoor E Nieboer; Neil Johnson; Emma Tavender; Ray Garry; Ben Willem J Mol; Kirsten B Kluivers Journal: Cochrane Database Syst Rev Date: 2015-08-12