Ignorance of electrosurgery among obstetricians and gynaecologists

Abstract

Objective: The purpose of this study was to assess the level of skill of laparoscopic surgeons in electrosurgery.

Design: Subjects were asked to complete a practical diathermy station and a written test of electrosurgical knowledge.

Setting: Tests were held in teaching and non-teaching hospitals.

Sample: Twenty specialists in obstetrics and gynaecology were randomly selected and tested on the Monash University gynaecological laparoscopic pelvi-trainer. Twelve candidates were consultants with 9-28 years of practice in operative laparoscopy, and 8 were registrars with up to six years of practice in operative laparoscopy. Seven consultants and one registrar were from rural Australia, and three consultants were from New Zealand.

Methods: Candidates were marked with checklist criteria resulting in a pass/fail score, as well as a weighted scoring system. We retested 11 candidates one year later with the same stations.

Main outcome measures: No improvement in electrosurgery skill in one year of obstetric and gynaecological practice.

Results: No candidate successfully completed the written electrosurgery station in the initial test. A slight improvement in the pass rate to 18% was observed in the second test. The pass rate of the diathermy station dropped from 50% to 36% in the second test.

Conclusion: The study found ignorance of electrosurgery/diathermy among gynaecological surgeons. One year later, skills were no better.