A HOSPITAL REVIEW OF ADVANCED GYNECOLOGIC ENDOSCOPIC PROCEDURES

OBJECTIVE: Our purpose was to review the findings of a Gynecologic End oscopic Review Committee established to monitor and review operative e ndoscopic procedures performed by the staff at a large private hospita l, Swedish Hospital Medical Center, in Seattle. STUDY DESIGN: Hospital charts of patients undergoing the endoscopic procedures under review are pulled monthly, and the data are extracted, particularly as relate d to performance of the procedures, length of surgery and hospitalizat ion, and occurrence of complications. This study is a compilation of t he committee's review of a 15-month interval, Jan. 1, 1992, to March 3 1, 1993. RESULTS: Forty-two surgeons performed 227 endoscopic procedur es on 218 patients, 100 hysteroscopically and 127 laparoscopically. Si gnificant complication rates were associated with the transhysteroscop ic operative procedures and with many of the translaparoscopic procedu res, including oophorectomy, ovarian cystectomy, myomectomy, pelviscop ic lysis of adhesions, and laparoscopic-assisted vaginal hysterectomy. CONCLUSIONS: A significant complication rate was found for many of th e advanced endoscopic procedures performed at Swedish Hospital Medical Center, This is likely related to operator inexperience in performing relatively difficult endoscopic procedures involving new and ever-exp anding arrays of techniques and instruments.