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Experience reduces operative time, blood loss.

SAVANNAH, GA. -- Surgeons performing more than 20 minimally invasive suburethral sling procedures each year have the shortest operative time and the lowest estimated blood loss, according to a retrospective chart review of 108 procedures at one facility.

Mean operative time declined with increasing number of cases performed per year--53 minutes for 5 or fewer cases, 47 minutes for 6-20 cases, and 36 minutes for more than 20 cases, Dr. James Q. Pulvino, a fellow in urogynecology and reconstructive pelvic surgery at the University of Rochester (N.Y.), reported at the annual meeting of the Society of Gynecologic Surgeons.

Estimated blood loss (EBL) was also lowest for those surgeons performing the most cases per year. EBL greater than 200 cc was most common for those performing 5 or fewer cases per year--18%, compared with 9.8% and 0% for those with 6-20 cases and more than 20 cases per year, said Dr. Pulvino at the meeting jointly sponsored by the American College of Surgeons.

Women who underwent minimally invasive sling placement in 2006 were identified by CPT diagnosis. Patients who underwent sling placement concomitantly with any other procedure were excluded.

Overall, the women had a mean age of 53 years and a mean body mass index of 28.8 kg/[sub 2]. Eight (7%) had undergone a prior incontinence procedure. There were no significant differences in demographics or comorbidities among the women.

Slightly more than half (54%) of procedures were performed by urogynecologists, followed by general gynecologists (30%), and urologists (16%). Urogynecologists had a mean surgical time of 36 minutes, significantly lower than the other specialties.

Dr. Pulvino stated that he had no relevant financial relationships to disclose.


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Article Details
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Title Annotation:Gynecologic Surgery
Author:Wachter, Kerri
Publication:OB GYN News
Article Type:Brief article
Geographic Code:1USA
Date:Aug 1, 2008
Previous Article:Readmission rate higher for closed procedures.
Next Article:Surgeon behavioral failures key in liability claims.

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