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Minimally Invasive Surgery
Volume 2012, Article ID 289342, 6 pages
http://dx.doi.org/10.1155/2012/289342
Research Article

The Impact of Training Residents on the Outcome of Robotic-Assisted Sacrocolpopexy

1Division of Female Pelvic Medicine and Reconstructive Surgery, Departments of Obstetrics and Gynecology and Urology, University Hospitals Case Medical Center, MAC 5034, 11100 Euclid Avenue, Cleveland, OH 44106, USA
2Assiut University, Assiut School of Medicine, Assiut 71111, Egypt

Received 25 July 2012; Revised 31 August 2012; Accepted 23 September 2012

Academic Editor: Amanda Nickles Fader

Copyright © 2012 Mohamed A. Bedaiwy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To evaluate the surgical outcomes of robotic-assisted sacrocolpopexy (RASCP) before and after the incorporation of hands-on training for urology and gynecology residents. Study Design. Forty-one patients underwent RASCP between December 2008 and March 2010 with one surgeon. RASCP was performed in the context of surgical repair of complex pelvic organ prolapse and/or stress urinary incontinence. The first 20 cases (group I) were performed exclusively by the attending surgeon. In the last 21 cases (group II), the urology resident performed a 50% or more of the RASCP while the gynecology resident performed the supracervical hysterectomy. The primary outcome measure was vaginal vault support at 24 weeks postoperatively based on pelvic organ prolapse quantification (POP-Q). Results. Mean ± SD operative time for the entire surgery including RASCP was  min and median EBL was  mL. Patient demographics and stage of disease did not differ between groups. Procedure time, PACU time, blood loss, and intraoperative complications were similar between groups. Follow-up POP-Q evaluations demonstrated significant correction of all points on vaginal examination for both groups ( ). Conclusions. Incorporation of resident training during RASCP allows teaching of robotic surgery techniques in an effective manner without prolonging operative time or affecting the overall surgical outcome.