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Isoyama K, Matsuura M, Hayasaka M, Nagao S, Nishimura Y, Yoshioka T, Imai Y, Miyagi E, Suzuki Y, Saito T. Nationwide trends in and regional factors associated with minimally invasive hysterectomy for benign indications in Japan. Eur J Obstet Gynecol Reprod Biol 2023; 289:129-135. [PMID: 37660507 DOI: 10.1016/j.ejogrb.2023.08.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/18/2023] [Accepted: 08/28/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE To examine the prevalence trends of minimally invasive hysterectomy for benign indications in Japan and investigate regional disparities. STUDY DESIGN A retrospective cohort and ecological study using "The National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) Open Data". SETTING Nationwide Japan. PATIENTS Individuals who underwent hysterectomy for benign indications from 2014 to 2020. INTERVENTIONS Trend analysis of minimally invasive surgery (MIS) rates through laparoscopic hysterectomies (LH) and robotic-assisted laparoscopic hysterectomies (RA-LH) at the national and prefecture levels. Examination of regional factors contributing to the disparity in MIS implementation rates by second medical service area (SMSA). RESULTS The number of LH has increased from 16,016 in 2014 to 27,755 in 2020. The nationwide MIS hysterectomy rate increased from 29% in 2014 to 55% in 2020 (p less than 0.001). More than 50% of hysterectomies have been performed as MIS since 2019. There was an increasing trend in MIS rates in all age groups. All prefectures except one showed a significant upward trend (p less than 0.05) in the MIS rates, but MIS rates varied widely (23-84%). In a multivariable model, the MIS was more likely to be performed in the SMSAs in western Japan (p = 0.011), in the SMSAs where the number of laparoscopy-qualified gynecologists is 5-10 (p = 0.013), and 11 or higher (p less than 0.001). CONCLUSIONS This study reveals a shift towards minimally invasive surgery (MIS) in total hysterectomy procedures in Japan. However, significant disparities in the prevalence of MIS hysterectomy exist, potentially influenced by the number of laparoscopy-qualified gynecologists.
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Affiliation(s)
- Kyoko Isoyama
- Department of Gynecology, Sapporo Medical University, 291, West 16, South 1, Chuo-Ku, Sapporo, Hokkaido 060-8543, Japan
| | - Motoki Matsuura
- Department of Gynecology, Sapporo Medical University, 291, West 16, South 1, Chuo-Ku, Sapporo, Hokkaido 060-8543, Japan.
| | - Misa Hayasaka
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Midorigaokahigashi 2-1-1-1, Asahikawa, Hokkaido 078-8510, Japan
| | - Sachiko Nagao
- Department of Gynecology, Sapporo Medical University, 291, West 16, South 1, Chuo-Ku, Sapporo, Hokkaido 060-8543, Japan
| | - Yoko Nishimura
- Department of Gynecology, Sapporo Medical University, 291, West 16, South 1, Chuo-Ku, Sapporo, Hokkaido 060-8543, Japan
| | - Toshiki Yoshioka
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama 236-0004, Kanagawa, Japan
| | - Yuichi Imai
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama 236-0004, Kanagawa, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama 236-0004, Kanagawa, Japan
| | - Yukio Suzuki
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
| | - Tsuyoshi Saito
- Department of Gynecology, Sapporo Medical University, 291, West 16, South 1, Chuo-Ku, Sapporo, Hokkaido 060-8543, Japan
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Vila Rabell M, Barri Soldevila P. Papel de la histerectomía en el sangrado uterino anormal. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2023. [DOI: 10.1016/j.gine.2022.100815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Unal F, Atakul N, Turan H, Yaman Ruhi I. Evaluation of YouTube laparoscopic hysterectomy videos as educational materials during the COVID-19 era using the LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS) and LAP-VEGaS video assessment tool. J OBSTET GYNAECOL 2021; 42:1325-1330. [PMID: 34704513 DOI: 10.1080/01443615.2021.1962823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
With increasing numbers of laparoscopic hysterectomies, surgical trainees are compelled to learn more about endoscopy. Owing to coronavirus disease-related social distancing requirements, online education has gained prominence. Here, we aimed to investigate the laparoscopic hysterectomy video quality on YouTube using the LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS). YouTube was searched on June 7, 2020 using 'laparoscopic hysterectomy'. Three examiners evaluated videos using Global Operative Assessment of Laparoscopic Skills (GOALS). Subsequently, videos were assessed for their conformity to the LAP-VEGaS and LAP-VEGaS Video Assessment Tool. Interobserver reliability was estimated using intraclass coefficients and Cronbach's alpha. Cochran's Q test was used to determine correlations among quantitative data. The median GOALS score was 21.50. The observers' GOALS scores were significantly correlated. The results showed low conformity to the LAP-VEGaS. YouTube is the most used platform among trainees. The low YouTube video educational quality highlights the necessity for peer review, as trainees increasingly seek such resources during the pandemic.IMPACT STATEMENTWhat is already known on this subject? YouTube is the most commonly used online resource for educational material among surgical trainees. Online videos usually do not undergo a peer-review process. The LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS) may be used to assess the educational quality of surgical videos.What do the results of this study add? To our knowledge, this is the first study on the quality of laparoscopic hysterectomy videos available on YouTube and the first study to evaluate YouTube laparoscopic surgery videos using the LAP-VEGaS Video Assessment Tool (VAT). Our study revealed the low educational quality of YouTube laparoscopic hysterectomy videos. The LAP-VEGaS VAT seems to be a valid and practical tool for assessing online laparoscopic hysterectomy videos.What are the implications of these findings for clinical practice and/or further research? Medical communities, especially tertiary care or academic centres, may upload educational peer-reviewed videos for trainees seeking this type of resource, especially during the coronavirus disease pandemic, as surgical education alternatives are limited.
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Affiliation(s)
- Fehmi Unal
- Department of Obstetrics and Gynecology, Istanbul Teaching and Research Hospital, Istanbul, Turkey
| | - Nil Atakul
- Department of Obstetrics and Gynecology, Istanbul Teaching and Research Hospital, Istanbul, Turkey
| | - Hasan Turan
- Department of Gynecologic Oncology, Cam Sakura City Hospital, Istanbul, Turkey
| | - Irem Yaman Ruhi
- Department of Obstetrics and Gynecology, Istanbul Teaching and Research Hospital, Istanbul, Turkey
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