Implementation of laparoscopic sacrocolpopexy--a single centre's experience.

Abstract

Introduction and hypothesis: The aim of this study was to describe the learning curve of a single surgeon to achieve the ability to perform a complication-free and anatomically successful laparoscopic sacrocolpopexy (LSC).

Methods: All patients, from the first LSC onwards (1996) were included. Outcome measures were operation time, number of laparotomies, complications and anatomical failures within 3 months. Learning curves were generated using moving average method (MOA) and cumulative sum (CUSUM) analysis to assess changes in respectively operation time and failures (laparotomy, complication or anatomical failure).

Results: Of the 206 patients, 83% were completed by laparoscopy. The intra-operative and major respectively minor post-operative complication rates were 2.4% (n = 5), 4.4% (n = 9) and 12.6% (n = 26). CUSUM analysis showed adequate learning after 60 cases. MOA showed that operation time declined rapidly during the first 30 procedures reaching a steady state (175 min) after 90 cases. Complications remained unchanged throughout the series.

Conclusions: LSC was associated with a low complication rate but a long learning curve.