Learning curve of hysteroscopic placement of tubal sterilization microinserts in 15 gynecologists in the Netherlands  

Oleh:

Janse, Julienne A. ; Pattij, Thyrza O.S. ; Eijkemans, Marinus J.C. ; Broekmans, Frank J.M. ; Veersema, Sebastiaan

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Fertility and Sterility (keterangan: ada di ClinicalKey) vol. 100 no. 03 (Sep. 2013), page 755-760.
Topik: Essure; experience; hysteroscopy; learning curve; sterilization

Ketersediaan

Perpustakaan FK Nomor Panggil: F02.K.2013.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Objective To evaluate the learning curve of hysteroscopic placement of tubal sterilization microinserts by gynecologists in the Netherlands. Design Prospective multicenter study (Canadian Task Force II-2). Setting Ten community (teaching) hospitals in the Netherlands. Patient(s) A total of 631 women who underwent permanent sterilization by tubal microinserts. Intervention(s) Hysteroscopic placement of tubal sterilization microinserts performed by 15 gynecologists experienced in performing operative hysteroscopy, starting from their very first placement. Main Outcome Measure(s) Effect of increasing experience in time on procedure time, pain score, successful bilateral placement, and complications. Result(s) Bilateral successful placement with confirmation of adequate positioning at follow-up evaluation was achieved in 480 (76.1%) patients at first attempt and in 44 (7.0%) at second attempt. Median procedure time was 8.0 minutes (range: 3–40), and 31 (4.9%) patients were lost to follow-up evaluation. Gravidity showed to be a confounding factor and was consequently adjusted for. A learning curve was seen in a statistically significant decrease of procedure time with increasing experience. The decrease in procedure time extended to 11 to 15 cases and was followed by a plateau phase of the subsequent 60 cases. In contrast, pain scores, successful placement, and complication rate appeared not to improve with increasing experience. Conclusion(s) A learning curve for hysteroscopic tubal sterilization was seen for procedure time, but successful placement, pain score, and complication rate were not clearly influenced by increasing experience.

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