The Impact of Annual Surgical Volume on Patient Outcomes in Laparoscopic Hysterectomy

TranArthur-Quan,; GreeneNaomi,; CassIlana,

doi:10.1089/gyn.2017.0113

Cited by 1 publication

(1 citation statement)

References 31 publications

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“…There are no standard definitions for low-volume versus high-volume surgeons in the literature [13]. With respect to hysterectomy, one study has defined a high-volume surgeon as performing >116 hysterectomies per year, [14] and another study has defined it as performing >16 hysterectomies per year [15]. Therefore, the definitions of low-, medium-, and high-volume surgeons were not provided to the respondents.…”

Section: Methodsmentioning

confidence: 99%

Barriers to Referral to Fellowship-trained Minimally Invasive Gynecologic Surgery Subspecialists

Delara¹,

Misal²,

Yi³

et al. 2021

Journal of Minimally Invasive Gynecology

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Study Objective: To determine patterns and barriers for referral to fellowship-trained minimally invasive gynecologic surgeons. Design: Questionnaire. Setting: United States and its territories and Canada. Participants: Actively practicing general obstetrician/gynecologists (OB/GYNs). Interventions: Internet-based survey. Measurements and Main Results: Of 157 respondents, 144 (91.7%) general OB/GYNs were included. Subspecialty fellowship training resulted in the exclusion of 13 ( 8.3%) respondents. A total of 86 respondents (59.7%) considered referral to fellowship-trained minimally invasive gynecologic surgery (MIGS) subspecialists. The top 3 cited reasons for nonreferral were adequate residency training (n = 84, 58.3%), preference for continuity of care (n = 48, 33.3%), and preference for referral to other subspecialists (n = 46, 31.9%). The top 3 cited reasons for referral to MIGS subspecialists were complex pathology (n = 92, 63.9%), complex medical and/or surgical history (n = 76, 52.8%), and out of scope of practice (n = 53, 36.8%). If providers required intraoperative assistance, respondents consulted an OB/GYN colleague with comparable training (n = 50, 34.7%), gynecologic oncologist (n = 48, 33.3%), or non-OB/GYN surgical subspecialist (n = 33, 22.9%). Factors that were not associated with the decision to refer to MIGS subspecialists included years in practice (p = .13), additional training experiences beyond residency (p = .45), and number of hysterectomies performed by laparotomy (p = .69). Selfreported high-volume surgeons (p <.01) were less likely to refer. In contrast, providers who self-reported as low-volume surgeons (p = .02) and were aware of MIGS subspecialists in the community (p <.01) were more likely to consider referral. Respondents reported using a laparoscopic approach to hysterectomy most frequently (n = 79, 54.9%). In contrast, 36.8% preferred the laparoscopic route for themselves or their partner, whereas 48.6% preferred the vaginal approach. Conclusion: Most of the general OB/GYNs would consider referral to fellowship-trained MIGS subspecialists. Providers who reported adequate residency training and those who preferred continuity of care or referral to other surgical subspecialists were less likely to refer to MIGS subspecialists.

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Section: Methodsmentioning

confidence: 99%