Authors: Wallenstein MR, Ananth CV, Kim JH, Burke WM, Hershman DL, Lewin SN, Neugut AI, Lu YS, Herzog TJ, Wright JD.
Study from: Columbia University College of Physicians and Surgeons, New York,
Journal: Obstetrics and Gynecology. 2012;119:709-16.
Problem: Studies from other surgical specialties show that surgeons who regularly perform operations have better results than those who perform surgery less often. This issue has not been studied for laparoscopic surgery for gynecologic procedures.
Study: The authors examined the hospital records of 124,615 patients who underwent laparoscopic hysterectomy from 2000 to 2010. The influence of surgeon and hospital volume on complication rates and costs was examined.
Results: Low-volume surgeons had a complication rate of 6.2% while the rate for high-volume surgeons was 4.2% (one-third lower). Complications during surgery, medical complications, long hospital stays and blood transfusion rates were less frequent for high-volume surgeons.
Women operated on at hospitals that did laparoscopic procedures frequently were 18% less likely to experience a complication than hospitals that did the procedures infrequently. The cost of surgery was $867 lower for high-volume surgeons than for low-volume surgeons.
Authors’ Conclusions: Performance of laparoscopic surgery by high-volume surgeons and at high-volume hospitals is associated with a reduction in complications and lower costs.
Dr. Parker’s Comments:
Unfortunately, this study deals with laparoscopic hysterectomy rather than the uterine-conserving procedure laparoscopic myomectomy, but the results should be the same for all advanced laparoscopic procedures. As demonstrated for chess masters, virtuoso musicians and airline pilots, it takes thousands of hours of experience to gain expertise. Surgical experience accumulates over years and results get better when procedures are performed on a regular basis. Determining the skill and experience of a surgeon is vital information for you to have. Some questions you should ask any doctor who you might consider to perform your surgery:
1) How many of this specific surgical procedures does the doctor perform a month?
2) How many of these procedures has he or she performed on women with conditions or problems like yours?
3) How many complications have occurred with this doctor’s surgeries, and what kind of complications were they?
You can see more about this topic here: Questions Everyone Should Ask Their Doctor Before Surgery
It is your body and your health and you have a right to ask these questions.
