Learning curve and surgical outcome for single-port access total laparoscopic hysterectomy in 100 consecutive cases.

Abstract

AIMS: To define the learning curve for single-port access (SPA) total laparoscopic hysterectomy (TLH) and evaluate the surgical outcomes.

METHODS: Patient demographics and segmental operating times of all 100 patients who underwent SPA-TLH by a single surgeon were analyzed. Patients were arranged in order based on surgery date.

RESULTS: 100 patients underwent SPA-TLH. There was no conversion to conventional laparoscopy or laparotomy. The median time until the removal of a specimen (T(R)) was 45 min and the median time for closure of the vaginal cuff (T(C)) was 18 min. The median total operating time from skin opening to closure (T(O)) was 80 min. T(R), T(C), and T(O) decreased significantly over the study period. The T(C) decreased significantly from the first 20 cases to the next 20 (p = 0.028) and the T(O) from the second 20 cases to the next 20 (p = 0.029).

CONCLUSIONS: Proficiency for SPA-TLH was achieved after 40 cases. Operating time and postoperative hemoglobin drop decreased with experience, without increasing complication.