LAPAROSCOPICALLY DIRECTED OVARIAN CYSTECTOMY IN PREMENOPAUSAL WOMEN -IMPACT OF SURGICAL EXPERIENCE ON SURGICAL TIME

The purpose of this study was to correlate surgical experience with op erating efficiency. A retrospective review of 303 operative laparoscop ic procedures was performed during a 48-month interval and during the acquisition of surgical skills by one faculty member. Population demog raphics and surgery time were evaluated in 41 cases (13.5%) of ovarian cystectomy. Patients were categorized into fertility-related or gynec ologic indications for surgery. Surgical time for successful laparosco pically directed resection of benign ovarian cysts was significantly r educed over the study interval (P = .008). Endometrioma was the most c ommon pathologic finding in women with impaired fertility, and benign epithelial tumors were the lesion encountered most commonly in gynecol ogic patients. Benign teratoma occurred infrequently in both groups. N o malignancy was observed in this group of premenopausal women, who ha d unilocular cysts less than 8 cm in diameter. Reduction in surgical t ime for laparoscopically directed ovarian cystectomy occurs after expe rience is gained by repeated application of the technique.