Total laparoscopic hysterectomy has been shown to be a safe metho

Total laparoscopic hysterectomy has been shown to be a safe method of hysterectomy with minimal complications [1], yet only 12% of hysterectomies are performed by this route, with 22% by vaginal approach and 66% still being performed Belinostat by laparotomy [2]. Surgeons have been encouraged to employ vaginal and laparoscopic routes for hysterectomy, but concerns exist about how to increase laparoscopic suturing skills without elevating risk to patients [3]. Currently available educational methods include broadly focused annual continuing medical education courses, mail-order instructional videos, informal mentoring, suture skills, and, more recently, comprehensive courses focused entirely on total laparoscopic hysterectomy and its component skills.

Such courses combine videos, slide lectures, and precepted and laparoscopic practice simulation trainers all focused on the specific steps to perform minimally invasive surgery [4]. The impact of such a comprehensive course on the gynecologic surgeon’s self-perceived skill level and practice patterns has not been established. Since 2004, a course focused on total laparoscopic hysterectomy (TLH) has been jointly sponsored by the American College of Obstetricians and Gynecologists for continuing medical education of gynecologic surgeons. This course extensively employs surgical simulators to train surgeons in laparoscopic suturing and knot tying. A simulation for suturing was developed to require that six ��figure-of-N�� sutures be placed through twelve dots and required four square knots to close. This ��Holiotomy�� was completed by 88% of surgeons.

It is hypothesized that a comprehensive course employing simulators would improve participant’s Dacomitinib self-perceived laparoscopic skill levels. It was further hypothesized that after three months these changes would manifest with more TLHs and other minimally invasive surgeries being reported in their practice pattern. 2. Methods Investigational Review Board approval of the survey protocol was obtained through Sequoia Hospital in Redwood City, California. The survey (see 2009 LIGO COURSE ATTENDEE QUESTIONAIRE) was distributed to all physician attendees at the Laparoscopic Institute for Gynecologic Oncology 4th annual course on Total Laparoscopic Hysterectomy. It was collected before the first morning break. Each questionnaire was numbered and stapled to a sealed, stamped envelope containing a similarly numbered questionnaire with a self-addressed stamped envelope for return. The attendees addressed the outer envelopes to themselves and handed these in with the completed precourse survey. The hand-addressed envelopes containing the second survey and a stamped return envelope were mailed to the course participants 90 days after completion of the course.

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