International urogynecology journal vol:20 issue:9 pages:1119-1125
Introduction and hypothesis The aim of this study was to
describe the learning curve of a single surgeon to achieve
the ability to perform a complication-free and anatomically
successful laparoscopic sacrocolpopexy (LSC).
Methods All patients, from the first LSC onwards (1996)
were included. Outcome measures were operation time,
number of laparotomies, complications and anatomical failures
within 3 months. Learning curves were generated using
moving average method (MOA) and cumulative sum
(CUSUM) analysis to assess changes in respectively operation
time and failures (laparotomy, complication or anatomical
Results Of the 206 patients, 83% were completed by
laparoscopy. The intra-operative and major respectively
minor post-operative complication rates were 2.4% (n=5),
4.4% (n=9) and 12.6% (n=26). CUSUM analysis showed
adequate learning after 60 cases. MOA showed that
operation time declined rapidly during the first 30 procedures
reaching a steady state (175 min) after 90 cases.
Complications remained unchanged throughout the series.
Conclusions LSC was associated with a low complication
rate but a long learning curve.