Although vaginal hysterectomy is associated with better outcomes and fewer complications, it only makes up a minority of hysterectomies performed. In efforts to change this trend, in 2012 the Urogynecology division members of Baystate Medical Center's obstetrics and gynecology residency program decided to perform the hysterectomy portion of robotically assisted sacrocolpopexy procedures vaginally. We evaluated the effect of this initiative on the number of vaginal hysterectomies performed per resident at graduation and the average operating time in an obstetrics and gynecology (Ob-Gyn) residency program.
We used the Accreditation Council for Graduate Medical Education case logs to determine the average number of vaginal hysterectomies performed per resident from July 1, 2007 through June 30, 2014. We obtained the average operating time for cases performed before and after the initiative.
The year prior to introduction of the robot in our institution, residents graduated with an average of 29 vaginal hysterectomies. This dropped to an average of 18 cases before 2012. After the initiative, this figure increased to an average of 30 vaginal hysterectomies per resident. Operating room time for robotic assisted laparoscopic hysterectomy with sacrocolpopexy versus a combined vaginal hysterectomy and robotic sacrocolpopexy decreased from 197 minutes to 165 minutes.
Transition from robotic hysterectomy and sacrocolpopexy to a combined vaginal hysterectomy and robotic sacrocolpopexy resulted in not only an increased number of vaginal hysterectomies performed by residents but also a decrease in operating room time.
Baystate Med Ctr/Tufts Univ, Springfield, MA
Financial Disclosure: The authors did not report any potential conflicts of interest.