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Federación Mexicana de Ginecología y Obstetricia, A.C.

2019, Number 07

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Ginecol Obstet Mex 2019; 87 (07)

Experience of the surgical team and level of difficulty of the intervention. Significant variables in the incidence of complications during laparoscopic gynecological surgery?

Pantoja-Garrido M, Frías-Sánchez Z, de la Chica-Rubio V, Peláez-Marín G

Language: Spanish
References: 21
Page: 417-424
PDF size: 257.29 Kb.


ABSTRACT

Objective: Primary: to observe whether the degree of difficulty of the intervention and the experience of the surgical team influence the incidence of complications and adverse consequences of laparoscopic gynecological surgery. Secondary: to assess which of the two variables influences more negatively and, in addition, to study the mechanisms that can be implemented in daily, clinical and educational practice to reduce the adverse surgical consequences.
Materials and Methods: Retrospective, observational and descriptive study carried out in the Virgen Macarena University Hospital of Seville, between January 2015 and February 2016. Including all laparoscopic surgeries performed for benign pathology in that period. The sample has been divided into 3 groups according to the distribution of the surgeons, taking into account their surgical experience. On the other hand, the interventions have been categorized according to the difficulty in three levels (with 3 being the most difficult).
Results: 195 laparoscopic surgeries have been collected. The experience of the surgical team has been a factor that has shown heterogeneous results, so the level of difficulty of the intervention seems more related to the surgical adverse effects. Regarding the level of difficulty prior to surgery, only surgical time and blood loss were statistically significant, which was greater in level 3 interventions. Variables such as average hospital stay, reoperations, readmission, conversion to laparotomy or complications were also higher in the group of level 3 of difficulty and lower in group 1, but without statistical significance.
Conclusion: The results raise the theory of which the level of difficulty of the intervention influences of more direct form in the surgical complications that the surgical experience of the surgeon and the assistant.


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