Evidence map›Paper›PMID 28889173›Full record

ArticleInternational urogynecology journal2018

The impact of fellowship surgical training on operative time and patient morbidity during robotics-assisted sacrocolpopexy.

Charelle M Carter-Brooks, Angela L Du, Michael J Bonidie, Jonathan P Shepherd

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Article in International urogynecology journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

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3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Charelle M Carter-BrooksDepartment of Obstetrics, Gynecology and Reproductive Sciences of the University of Pittsburgh, 300 Halket Street, Suite, Pittsburgh, PA, 2323, USA. cartercm4@upmc.edu.ORCID http://orcid.org/0000-0001-7080-9145
Angela L DuUniversity of Pittsburgh, School of Medicine, Pittsburgh, PA, USA.
Michael J BonidieDepartment of Obstetrics, Gynecology and Reproductive Sciences of the University of Pittsburgh, 300 Halket Street, Suite, Pittsburgh, PA, 2323, USA.
Jonathan P ShepherdDepartment of Obstetrics and Gynecology, Trinity Health Of New England, Hartford, CT, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introduction and hypothesisAbdominal sacrocolpopexy is commonly performed for the surgical correction of pelvic organ prolapse (POP) in the USA. Over the last decade, fellowship programs have increased the number of these procedures performed robotically. Currently, there is a paucity of literature exploring the impact of fellowship training on outcomes of robotic-assisted sacrocolpopexy (RASC). We sought to explore the impact of an expert surgeon operating alone versus with a fellow on operative time and perioperative morbidity associated with RASC.

methodsThis is an analysis of a retrospectively collected cohort of all RASCs performed to treat POP from June 2010 to August 2015 by a single attending surgeon. Outcomes were compared by expert surgeon alone and with a fellow.

resultsWe identified 208 RASCs, of which 124 (59.6%) were performed by an expert surgeon alone and 84 (40.4%) with a fellow. Eight fellows were included, with a median of 7 cases (interquartile range 5-13.5). Cases with fellows were 31.1 min longer than an expert surgeon alone (155.6 vs 124.5 min, p < 0.001), a 25% increase. Increased operative time for fellows remained significant on multivariate regression (34.2 min, p < 0.001) after adjusting for case order postmenopausal status, hysterectomy, mid-urethral sling, and bowel injury. Years in fellowship did not have an impact on operative time (p = 0.80). Complications were seen in 34 women (16.4%). On univariate regression, fellows did not have an impact on complications (OR 1.49, 95% CI [0.65-3.43]), which was unchanged on multivariate regression (OR 0.628, 95% CI [0.26-1.54]). Prolapse recurrence was seen in 19 women (9.5%). Fellows had no impact on prolapse recurrence (OR 0.478, 95% CI [0.17-1.38]), which was unchanged on multivariate regression (OR 0.266, 95% CI [0.17-1.49]).

conclusionWhen an expert surgeon operated together with a fellow, operative time increased by 34 min without increasing prolapse recurrence or complications.

Indexed as

Clinical CompetenceFellowships and ScholarshipsOperative TimeFemaleGynecologic Surgical ProceduresHumansLaparoscopyPelvic Organ ProlapseRetrospective StudiesRobotic Surgical ProceduresUrologic Surgical ProceduresPelvic organ prolapseRoboticsSacrocolpopexy

Identifiers

PMID28889173

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.