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53 The implementation of a standardized surgical training program for specialist gynaecologists to decrease the rate of open, abdominal hysterectomy
  1. M Janda1 and
  2. A Obermair2
  1. 1The University of Queensland, Centre for Health Services Research, Brisbane, Australia
  2. 2The University of Queensland, Queensland Center for Gyanecological Cancer, Brisbane, Australia


Objectives Hysterectomy is the most common major gynaecological procedure in Australia. Evidence suggests that Total Abdominal Hysterectomy (TAH) is associated with longer hospital stay, protracted recovery and worse postoperative quality of life and increased cost. Despite this evidence, the decline TAH is slow in Australia compared to internationally.

Methods We developed a prototype of training specialist gynaecologists in Total Laparoscopic Hysterectomy (TLH). The pillars of training include Baseline assessment of surgical outcomes; Identification of trainee surgeons and institutions; Development of a governance and support structure; Preceptorship; Proctorship; Comparison of surgical outcomes with baseline. Data collection includes intraoperative and postoperative complications from the trainee surgeons as well as from surgeons who do not receive the surgical training intervention.

Results Four public hospitals received approval for surgical training and three of these commenced training. A total of 46 surgical training cases have been completed to date. One hospital completed all 10 training days with all three gynaecologists passing their TLH training. These gynaecologists currently offer TLH to their patients and have been successfully converted from “open” surgeons to “laparoscopic” surgeons. Another two hospital units totalling 6 gynaecologists completed most of their training days, one is about to start.

Conclusions A standardized surgical outreach training program for specialist gynaecologists seems to be of interest to hospitals and surgeons, and may be a future way to roll out surgical innovations to practising surgically orientated gynaecologists. Future data analyses will assess whether the program results in reduced hospital stay, surgical complications, better postoperative quality of life and reduced cost.

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