The effect of experience on the outcomes of total laparoscopic hysterectomy surgery: 1295 cases

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 university hospital. Patients: 1295 cases with 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 opera-tions 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 hemoglobin drop and the duration of hospitalization in the groups with increased experience (p = 0.021, p < 0.001, respectively). There was no increase in uterine specimen weight with increased experi-ence (p = 0.267).Conclusions: We obtained that the peak value in the learning curve could not 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. As the trend of minimally invasive surgery will continue to increase in the next century due to higher patient comfort, all gynecologists should gain competence in endoscopic surgery.