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Impact of surgeon experience on routine prolapse operations
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology.ORCID iD: 0000-0003-3988-6323
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology.
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2018 (English)In: International Urogynecology Journal, ISSN 0937-3462, E-ISSN 1433-3023, Vol. 29, no 2, p. 297-306Article in journal (Refereed) Published
Abstract [en]

Introduction and hypothesis: Surgical work encompasses important aspects of personal and manual skills. In major surgery, there is a positive correlation between surgical experience and results. For pelvic organ prolapse (POP), this relationship has to our knowledge never been examined. In any clinical practice, there is always a certain proportion of inexperienced surgeons. In Sweden, most prolapse surgeons have little experience in performing prolapse operations, 74% conducting the procedure once a month or less. Simultaneously, surgery for POP globally has failure rates of 25-30%. In other words, for most surgeons, the operation is a low-frequency procedure, and outcomes are unsatisfactory. The aim of this study was to clarify the acceptability of having a high proportion of low-volume surgeons in the management of POP.

Methods: A group of 14,676 exclusively primary anterior or posterior repair patients was assessed. Data were analyzed by logistic regression and as a group analysis.

Results: Experienced surgeons had shorter operation times and hospital stays. Surgical experience did not affect surgical or patient-reported complication rates, organ damage, reoperation, rehospitalization, or patient satisfaction, nor did it improve patient-reported failure rates 1 year after surgery. Assistant experience, similarly, had no effect on the outcome of the operation.

Conclusions: A management model for isolated anterior or posterior POP surgery that includes a high proportion of low-volume surgeons does not have a negative impact on the quality or outcome of anterior or posterior colporrhaphy. Consequently, the high recurrence rate was not due to insufficient experience of the surgeons performing the operation.

Place, publisher, year, edition, pages
Springer, 2018. Vol. 29, no 2, p. 297-306
Keywords [en]
pelvic organ prolapse, national register data, patient-reported outcome, surgical outcome, quality control, learning curve
National Category
Surgery
Identifiers
URN: urn:nbn:se:umu:diva-144825DOI: 10.1007/s00192-017-3353-0ISI: 000423154300017PubMedID: 28577172OAI: oai:DiVA.org:umu-144825DiVA, id: diva2:1187473
Note

Errata: Nüssler, E., Eskildsen J. K., Nüssler, E. K., Bixo, M., Löfgren, M. Impact of surgeon experience on routine prolapse operations. International Urogynecology Journal 2018;29:2. DOI: 10.1007/s00192-017-3525-y

Available from: 2018-03-05 Created: 2018-03-05 Last updated: 2018-06-09Bibliographically approved

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Nüssler, EmilEskildsen, Jacob KjaerNüssler, Emil KarlBixo, MarieLöfgren, Mats
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