Objectives: To reveal the effect of surgeon's experience on the outcomes of the total laparoscopic hysterectomy (TLH) surgery.
Material and methods: Design: Retrospective case series.
Setting: A tertiary care university hospital.
Patients: 1295 cases with an indication for hysterectomy.
Interventions: Total laparoscopic hysterectomy.
Results: All cases were grouped according to the surgeon's experience. For 30 different surgeons, their first 20 operations constituted Group A, 21st-50th operations Group B, 51st-100th operations Group C, and their operations after the 100th surgery Group D. Demographic data and post-operative results were compared between the groups. There were no statistical differences in terms of demographic data and major complications. A statistically significant decrease was observed in the post-operative fall in hemoglobin level and the duration of hospitalization in the groups with increased experience (p = 0.021, p < 0.001, respectively). There wasn't an increase in uterine specimen weight with increased experience (p = 0.267).
Conclusions: We obtained that the peak value in the learning curve cannot be evaluated according to the operation time or complication rates. Although the complication rate seems unaffected by surgical experience, concerns about complications may decrease as experience increases. Since the trend of minimally invasive surgery will continue increasingly in the next century because of higher patient comfort, all gynecologists should gain competence in endoscopic surgery.
Keywords: complications; hysterectomy; laparoscopy; learning curve; outcomes.