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KMID : 0358420100530100927
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Korean Journal of Obstetrics and Gynecology
2010 Volume.53 No. 10 p.927 ~ p.933
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Learning curves of total laparoscopic hysterectomies in three gynecologists
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Oh Yoon-Kyung
Hwang Hyo-Soon
Yi Kyong-Wook
Song Seung-Hun
Lee Jae-Kwan
Hur Jun-Young
Shin Jung-Ho
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Abstract
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Objective: Total laparoscopic hysterectomy (TLH) is becoming more commonly used as an alternative to traditional abdominal hysterectomy and Analyzing the turning point of a learning curve can be useful in planning training programs. This study was to define the average turning point of a learning curve of TLH by comparing three separate gynecologists in one institute.
Methods: Retrospective analysis of the first 140 consecutive cases of TLH performed by three separate gynecologists A, B, and C. Patients of each gynecologist were divided into 7 equal groups of 20 operations classed chronologically. Patient’s age, uterus weight, operation time and pre-post operative hemoglobin difference of the three gynecologists were compared. Operation time and pre-post operative hemoglobin difference were evaluated to build learning curves for each gynecologist.
Results: Learning curve built by operation time showed turning point after 80~100 cases in all three gynecologists. Learning curve built by pre-post operative hemoglobin difference did not show a decreasing pattern. There were no statistical differences in patient’s age and pre-post operative hemoglobin difference between the three gynecologists. However, mean uterine weight of gynecologist C was significantly lighter than that of gynecologist A and B. Operation time was significantly longer in cases by gynecologist C than in cases by A and B.
Conclusion: At least 80~100 cases of experience in TLH is needed for a gynecologist to reach the turning point of the learning curve. This result can be used as a guide to the training program of TLH.
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KEYWORD
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Total laparoscopic hysterectomy, Learning curve, Turning point, Operating time, Hemoglobin difference
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