Learning Curve of Total Laparoscopic Hysterectomy for a Resident in a High-Volume Resident Training Setup.

Study Objective: To evaluate the resident learning curve, demographic and comparative analysis of total laparoscopic hysterectomy. Design: This retrospective observational study was conducted in a high-volume resident training setup. Setting: Tertiary care center is used in the study. Materials and Methods: Eight hundred and one total laparoscopic hysterectomy patients operated by the residents between July 2013 and June 2019 were evaluated with respect to the learning curve, duplication of the steps, the results in terms of intra- and postoperative complications and the time taken for the surgery. Surgeries were assigned as per the institutional inclusion criteria for the residents. The fellowship program enrolled six residents per year for training period of 1 year. The residents initially performed ten simple cases under the supervision of the director followed by ten cases which were performed independently, and based on their learning curve, they then performed advanced cases independently. Results: TLH was successfully performed in all women by surgical residents in training. The surgical time was 61-120 min in majority (49.3%). 2.99% had intra-operative complications while 7.61% had postoperative complications which were identified and managed. All women recovered uneventfully. Conclusions: Dedicated teaching staff, uniform surgical protocols and high-volume centers contribute to the safety of TLH.