R.C. Kung

The laparoscopic myomectomy: a survey of Canadian gynaecologists.

OBJECTIVE To survey all gynaecologists in Canada to determine the number who perform or offer the laparoscopic myomectomy (LM) procedure, the barriers that deter gynaecologists from performing or offering LM, and to understand the perceptions and attitudes of Canadian gynaecologists with respect to LM. METHODS A survey was developed, pre-tested, and distributed to all 1279 obstetrician-gynaecologists on the SOGC mailing list in April 2007. RESULTS A total of 529 obstetrician-gynaecologists participated in the survey a response rate of 41.4%. Of the 485 respondents who practised gynaecology, 119 (24.5%) performed LM, but only 15 (3.1%) stated that more than 50% of their myomectomies were performed laparoscopically. Two hundred twelve gynaecologists (44.3%) admitted to having referred a patient to another gynaecologist for LM. Laparoscopic surgeons felt the principal barrier to performing LM was lack of training in the procedure (70.7%). Gynaecologists felt the principal barrier to referring to another gynaecologist for LM was their uncertainty about who offered the procedure (33%). The majority of gynaecologists believed that LM has faster recovery time. The majority of respondents, however, were unsure which procedure is superior with respect to blood loss, adhesion formation, fertility rate post-procedure, uterine rupture rate in subsequent pregnancy, and cost-effectiveness. CONCLUSION Despite existing evidence that indicates that LM is comparable to abdominal myomectomy with respect to complication rates and fertility, only one quarter of Canadian gynaecologists who responded to this survey performed the procedure. Barriers to performing LM included lack of training and barriers to referral included uncertainty about who offered the procedure.

Cost Comparison of the Laparoscopic Burch Colposuspension, Laparoscopic Two-Team Sling Procedure, and the Transobturator Tape Procedure for the Treatment of Stress Urinary Incontinence

OBJECTIVE To compare medical costs of three surgical procedures for the treatment of primary stress urinary incontinence: the laparoscopic Burch colposuspension procedure, the laparoscopic two-team sling procedure, and the transobturator tape (TOT) procedure. METHODS We performed a retrospective observational study of isolated minimally invasive surgical procedures (no concomitant surgery) in 18 women with primary stress incontinence. Six women underwent a laparoscopic Burch colposuspension procedure, six underwent a laparoscopic two-team sling, and six underwent a TOT procedure. The main outcome measure was the mean aggregated medical cost per patient treated. Itemized calculations were made for (1) equipment costs; (2) surgeon, surgical assistant, and anaesthesiologist reimbursements; (3) nursing costs; (4) operating and recovery room costs; and (5) costs of stay in hospital. RESULTS The mean cost per patient undergoing a TOT procedure was

Postoperative Pubic Symphysis Osteomyelitis after Laparoscopic Two-team Sling with Anterior and Posterior Colporrhaphy

2547 (95% CI

Phase 1 development of an index to measure the quality of neuraxial labour analgesia: exploring the perspectives of childbearing women

2260 to

The Laparoscopic Myomectomy: A Survey of Canadian Gynecologists

2833); for a laparoscopic Burch colposuspension it was

Management of Abnormal Uterine Bleeding in the Emergency Department Setting: Trends Over the Last 10 Years [10H]

4354 (95% CI

O-GYN-MD-097 Factors Influencing Patients’ Willingness to Undergo Morcellation in Minimally Invasive Surgical Fibroid Treatment

3465 to

603 - A Novel Approach to Postoperative Pain Management in Vaginal Surgery: Bupivacaine Use in Vaginal Packing

5244); and for a laparoscopic two-team sling procedure it was

Multidisciplinary Laparoscopic Management of Severe Ureteral Endometriosis with Atrophic Kidney

5393 (95% CI

The Role of Mentorship on the Career Choices for Obstetrics and Gynecology Residents

4959 to