55: Five years experience with porcine extracellular matrix as an alternative to synthetics in pelvic reconstruction surgery for pelvic organ prolapse

Abstract

MATERIALS AND METHODS:This was a prospective, non-blinded study involving the gynecological residents over two academic years. This study took place at a single academic teaching center, Mt Sinai Hospital, in Manhattan, NY. Over two academic years, residents completed three visuospatial ability tests (snowy pictures, card rotation and form board) on two separate occasions and were evaluated on their performance in gynecologic surgeries using the Hopkins Assessment of Surgical Competency, a validated global rating scale consisting of the general skills and case skills subscales. Evaluations were included when the resident acted as the primary surgeon or first assistant and were excluded if the resident was the second assistant, or had not completed the visuospatial ability tests two times, one year apart. RESULTS: Between August 2014 and July 2016, 37 residents were enrolled and 468 surgical evaluations were included. Three visuospatial ability tests were compared to two years of surgical data, which demonstrated a trending correlation that was not statistically significant. As the card rotation test increased, so did the general skills (p ¼ 0.08) and case skills (p ¼ 0.04). There was no correlation between general skills (GS) or case skills (CS) and snowy pictures or form board. Eighteen residents took all three portions of the visuospatial ability tests on two separate occasions, one year apart. Comparing year 1 to year 2, the form board and snowy picture tests remained constant (p ¼ 0.0.17) and (p ¼ 0.24) respectively. The card score did increase significantly (p ¼ 0.0051). The residents' general skills and case skills did not significantly increase from year 1 (GS: 3.6/ CS: 3.66) to year 2 (GS 3.62/ CS: 3.52). CONCLUSION: Higher scores on the more complex visuospatial ability test trended towards better performance in the operating room. The form board and snowy picture test remained constant, making them useful tests in predicting surgical performance regardless of an individual's exposure to the operating room or previous visuospatial ability tests. Surgical skill (GS + CS) remained constant through the two years evaluations. Although higher card rotation scores correlated with higher scores in the operating room these scores also increased with time, limiting their usability in this type of testing. Longer-term evaluation of this testing is necessary to demonstrate its usefulness in pre-determination of surgical ability. OBJECTIVES:There is a lack of information on the overall effectiveness of phenazopyridine use to detect ureteral flow during gynecologic surgery. Since it is an oral agent, it can potentially have an unpredictable excretion time. The purpose of this study is to describe the effectiveness of phenazopyridine use for determining ureteral flow and the need for secondary agents if ureteral flow identification was initially inadequate. . Patients undergoing hysterectomy or urogynecologic procedures were identified through medical records.Patient demographics including age, reason for surgery, ren...