TY  - BOOK
AU  - Iglesia, Cheryl B
AU  - Janni, Megan
AU  - Richter, Lee
AU  - Tefera, Eshetu
TI  - Intraoperative Ureteral Kinking During Uterosacral Ligament Suspension: Effect of Training Level on Occurrence
SN  - 0024-7758
PY  - 2016///
KW  - *Clinical Competence/sn [Statistics & Numerical Data]
KW  - *Gynecologic Surgical Procedures/ae [Adverse Effects]
KW  - *Intraoperative Complications/ep [Epidemiology]
KW  - *Ligaments/su [Surgery]
KW  - *Surgeons/sn [Statistics & Numerical Data]
KW  - *Uterus/su [Surgery]
KW  - Female
KW  - Humans
KW  - Retrospective Studies
KW  - MedStar Health Research Institute
KW  - MedStar Washington Hospital Center
KW  - Medicine
KW  - Obstetrics and Gynecology/Female Pelvic Medicine and Reconstructive Surgery
KW  - Obstetrics and Gynecology/Urogynecology
KW  - Journal Article
N1  - Available in print through MWHC library:1999-2007
N2  - CONCLUSION: Ureteral kinking occurred in 6.2% of USLS procedures at a tertiary referral center and is associated with a learning curve with statistically significant higher kinking rates among less experienced surgeons. Novel teaching methods should be considered to reduce the learning curve for this procedure; OBJECTIVE: To determine the rate of ureteral kinking during uterosacral ligament suspension (USLS) procedures at a tertiary referral center and to describe the effect of surgical training level on this occurrence. The secondary aim is to determine the mean additional anesthesia time associated with management of this complication; RESULTS: A total of 161 USLS procedures were performed during the study period; 10 had ureteral kinking (6.2%). Level of surgeon training significantly impacted ureteral kinking, with higher rates of kinking occurring among surgeons in earlier training. The occurrence of ureteral kinking during USLS significantly increased the procedure. time by a mean of 86 minutes when the surgery included vaginal hysterectomy and anterior/ posterior colporrhaphy (266.5+/-34.6 min vs. 180.1 +/-43.0 min, respectively; p=0.0078); STUDY DESIGN: This retrospective cohort study included all USLS procedures at our tertiary referral center from June 2011 to December 2013. Cases of USLS with ureteral kinking were compared to uncomplicated cases to determine the impact of surgeon training level on this occurrence
ER  -