The Learning Curve for Laparoscopic Sacrocolpopexy Based on Dissection Skills if Structured Teaching and Standardized Surgery are Applied
Andreas Martin Studer,1 Jörg Krebs,2 Christine Brambs,1 Corina Christmann-Schmid1 1Department of Urogynecology, Cantonal Hospital of Lucerne, Lucerne, Switzerland; 2Neuro-Urology Research Group, Swiss Paraplegics Research, Nottwil, SwitzerlandCorrespondence: Andreas Martin Studer, Department of Urog...
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Dove Medical Press
2025-05-01
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| author | Studer AM Krebs J Brambs C Christmann-Schmid C |
| author_facet | Studer AM Krebs J Brambs C Christmann-Schmid C |
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| description | Andreas Martin Studer,1 Jörg Krebs,2 Christine Brambs,1 Corina Christmann-Schmid1 1Department of Urogynecology, Cantonal Hospital of Lucerne, Lucerne, Switzerland; 2Neuro-Urology Research Group, Swiss Paraplegics Research, Nottwil, SwitzerlandCorrespondence: Andreas Martin Studer, Department of Urogynecology, Cantonal Hospital of Lucerne, Lucerne, Switzerland, Email andreas.studer@luks.chPurpose: Teaching is an important but time- and resource-consuming process. Therefore, it is important to optimize and structure it effectively. The aim of this study was to evaluate if dry-lab suture and knotting training lead to stable theater performance. Consequently, the learning curve is supposed to be ascribed to only on-patient trainable skills like tissue preparation.Patients and Methods: To test this hypothesis, a structured training and stepwise surgical program were implemented to perform laparoscopic sacrocolpopexy (SCP) for urogynecological fellows adapting existing literature.The program was structured and recorded as following: dry-lab training weekly for knotting and suturing skills, assisting 20 SCP, stepwise overtaking defined steps under supervision including preparation of the dissecting planes anteriorly, posteriorly and at the level of the promontory, mesh fixation and retroperitoneal closure. All women opting for sacrocolpopexy as pelvic organ prolapse repair and being treated by one designated fellow were included without any specific selection. The only exclusion criterium was repeat sacrocolpopexy.Results: Within 45 procedures, the fellow reached a plateau of 80 minutes surgical time for SCP (excluding port-entry/-closure or concomitant interventions like hysterectomy or adnexectomy), with a complication rate of 11.1%. A high subjective and objective success rate was reported post-operatively. Differences in overall time were clearly correlated with overall dissection time.Conclusion: We demonstrated that a stepwise, structured, and standardized intraoperative surgical program facilitated safe and efficient laparoscopic SCP performance in the analyzed situation. Off-patient trainable skills like suturing and knotting led to consistent mesh fixation times from the start of the qualification process and variation arose due to in situ learnable factors.Keywords: education, urogynecology, pelvic organ prolapse, teaching |
| format | Article |
| id | doaj-art-dc5eba39cd6c49258aaf8f75c30c7f7c |
| institution | Kabale University |
| issn | 1179-7258 |
| language | English |
| publishDate | 2025-05-01 |
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| series | Advances in Medical Education and Practice |
| spelling | doaj-art-dc5eba39cd6c49258aaf8f75c30c7f7c2025-08-20T03:32:35ZengDove Medical PressAdvances in Medical Education and Practice1179-72582025-05-01Volume 16Issue 1917925103261The Learning Curve for Laparoscopic Sacrocolpopexy Based on Dissection Skills if Structured Teaching and Standardized Surgery are AppliedStuder AM0Krebs J1Brambs C2Christmann-Schmid C3UrogynaecologyNeuro-Urology Research GroupDepartment of Obstetrics and GynecologyDepartment of Obstetrics and GynecologyAndreas Martin Studer,1 Jörg Krebs,2 Christine Brambs,1 Corina Christmann-Schmid1 1Department of Urogynecology, Cantonal Hospital of Lucerne, Lucerne, Switzerland; 2Neuro-Urology Research Group, Swiss Paraplegics Research, Nottwil, SwitzerlandCorrespondence: Andreas Martin Studer, Department of Urogynecology, Cantonal Hospital of Lucerne, Lucerne, Switzerland, Email andreas.studer@luks.chPurpose: Teaching is an important but time- and resource-consuming process. Therefore, it is important to optimize and structure it effectively. The aim of this study was to evaluate if dry-lab suture and knotting training lead to stable theater performance. Consequently, the learning curve is supposed to be ascribed to only on-patient trainable skills like tissue preparation.Patients and Methods: To test this hypothesis, a structured training and stepwise surgical program were implemented to perform laparoscopic sacrocolpopexy (SCP) for urogynecological fellows adapting existing literature.The program was structured and recorded as following: dry-lab training weekly for knotting and suturing skills, assisting 20 SCP, stepwise overtaking defined steps under supervision including preparation of the dissecting planes anteriorly, posteriorly and at the level of the promontory, mesh fixation and retroperitoneal closure. All women opting for sacrocolpopexy as pelvic organ prolapse repair and being treated by one designated fellow were included without any specific selection. The only exclusion criterium was repeat sacrocolpopexy.Results: Within 45 procedures, the fellow reached a plateau of 80 minutes surgical time for SCP (excluding port-entry/-closure or concomitant interventions like hysterectomy or adnexectomy), with a complication rate of 11.1%. A high subjective and objective success rate was reported post-operatively. Differences in overall time were clearly correlated with overall dissection time.Conclusion: We demonstrated that a stepwise, structured, and standardized intraoperative surgical program facilitated safe and efficient laparoscopic SCP performance in the analyzed situation. Off-patient trainable skills like suturing and knotting led to consistent mesh fixation times from the start of the qualification process and variation arose due to in situ learnable factors.Keywords: education, urogynecology, pelvic organ prolapse, teachinghttps://www.dovepress.com/the-learning-curve-for-laparoscopic-sacrocolpopexy-based-on-dissection-peer-reviewed-fulltext-article-AMEPeducationurogynecologypelvic organ prolapseteaching |
| spellingShingle | Studer AM Krebs J Brambs C Christmann-Schmid C The Learning Curve for Laparoscopic Sacrocolpopexy Based on Dissection Skills if Structured Teaching and Standardized Surgery are Applied Advances in Medical Education and Practice education urogynecology pelvic organ prolapse teaching |
| title | The Learning Curve for Laparoscopic Sacrocolpopexy Based on Dissection Skills if Structured Teaching and Standardized Surgery are Applied |
| title_full | The Learning Curve for Laparoscopic Sacrocolpopexy Based on Dissection Skills if Structured Teaching and Standardized Surgery are Applied |
| title_fullStr | The Learning Curve for Laparoscopic Sacrocolpopexy Based on Dissection Skills if Structured Teaching and Standardized Surgery are Applied |
| title_full_unstemmed | The Learning Curve for Laparoscopic Sacrocolpopexy Based on Dissection Skills if Structured Teaching and Standardized Surgery are Applied |
| title_short | The Learning Curve for Laparoscopic Sacrocolpopexy Based on Dissection Skills if Structured Teaching and Standardized Surgery are Applied |
| title_sort | learning curve for laparoscopic sacrocolpopexy based on dissection skills if structured teaching and standardized surgery are applied |
| topic | education urogynecology pelvic organ prolapse teaching |
| url | https://www.dovepress.com/the-learning-curve-for-laparoscopic-sacrocolpopexy-based-on-dissection-peer-reviewed-fulltext-article-AMEP |
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