2988 Patient Perceptions of Laparoscopic and Robotic Gynecologic Surgery

Abstracts / Journal of Minimally Invasive Gynecology 26 (2019) S98−S231 Jong A,1,* Besharati M,2 Main JS2. 1Obstetrics and Gynecology, Santa Clara Valley Medical Center, San Jose, CA; 2Santa Clara Valley Medical Center, San Jose, CA *Corresponding author. Study Objective: We sought to improve laparoscopic skills amongst OB/ GYN residents via a “peer-coaching” model. We hypothesized that if residents were paired in a “resident as educator” model, the simulation training would be beneficial to both parties. Design: From October 2016 until May 2017, we performed a randomized controlled trial to assess the impact of a “peer-coaching” model. Sixteen OB/GYN residents were randomized into either individual practice (control group) or practice with a junior-senior combination (intervention group). Residents underwent a baseline assessment and an assessment six months later of two FLS tasks: peg transfer and precision circle-cutting. Scores were determined by time to completion and GOALS score (a validated assessment tool for grading proficiency for laparoscopy). Setting: Community-academic hospital Patients or Participants: See Design. Interventions: See Design. Measurements and Main Results: The GOALS score for both the peg transfer and circle cutting for the residents in the individual practice group improved an average of 2 points (p value=0.54 and 0.56 respectively). The peer-coaching group improved 5 points for the peg transfer (p=0.07) and 2 points for the circle cutting (p=0.62). The average difference in time to complete the circle-cutting activity for individuals in the control group was -62 seconds (p=0.08). The peer-coaching group also decreased their average time to complete the task by 97 seconds (p=0.48) Conclusion: A ‘peer-coaching’ model does not significantly impact technical improvement. This study highlighted the limitations of implementing simulation practice into an OBGYN residency. As this study was intended as a quality improvement project, a new curriculum with protected simulation training was created. A survey noted that 100% of residents reported this intervention was highly effective in improving compliance with FLS practice and improvement of skills. Virtual Poster Session 2: Basic Science/Research/Education (1:30 PM − 1:40 PM) 1:30 PM: STATION O 2988 Patient Perceptions of Laparoscopic and Robotic Gynecologic Surgery To JK,1,* Arya P,1 Barros Sierra S2. 1OB/GYN, Flushing Hospital Medical Center, Flushing, NY; 2Ross University, Miramar, FL *Corresponding author. Study Objective: To clarify the health literacy and needs of patients undergoing laparoscopic and robotic surgery Design: Survey Setting: Urban community hospital Patients or Participants: Patients waiting to undergo minimally invasive gynecologic surgery Interventions: A 23 question survey was administered to patients waiting for surgery. Patients were educated on minimally invasive surgery after completing their survey. Measurements and Main Results: 105 patients were surveyed. 51.4% of patients had heard of the term "laparoscopy." However 63.8% of patients were familiar with the term "robotic surgery." Only 36.2% had reported hearing these terms from their physician. Patients correctly answered 48.1% of questions that dealt with the benefits of minimally invasive surgery. Only 3.8% of patients thought that a robot worked autonomously during robotic surgery. Conclusion: There may be significant gaps between what clinicians discuss with their patients and what patients recall and comprehend. Further study is necessary to elucidate "best practices" for surgical consenting.

S157 Virtual Poster Session 2: Basic Science/Research/Education (1:30 PM − 1:40 PM) 1:30 PM: STATION P 1180 Factors that Influence Applicants Pursuing A Fellowship in Minimally Invasive Gynecologic Surgery (FMIGS) Traylor J,* Friedman J, Runge M, Tsai SC, Chaudhari A, Milad MP. Department of Obstetrics and Gynecology, Division of Minimally Invasive Gynecologic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL *Corresponding author. Study Objective: The Fellowship in Minimally Invasive Gynecologic Surgery (FMIGS) has been the most competitive fellowship in Obstetrics and Gynecology since 2015. Since its inception, it has served to provide advanced endoscopic training and addresses the need for additional proficiency beyond residency. We sought to identify factors that influence applicants in choosing to pursue MIGS training. Design: Cross-sectional study. Setting: 2018 FMIGS Application Cycle. Patients or Participants: FMIGS applicants. Interventions: A novel, 32-item web-based survey was distributed to all FMIGS applicants during the 2018 application cycle. Measurements and Main Results: Descriptive statistics were used to characterize the applicant sample and responses. Our survey response rate was 47.4% (37/78). Interest in the subject area of minimally invasive gynecologic surgery was the single most influential factor driving applicants to pursue FMIGS, followed by an interest in an academic career. Income level was the least important factor in their decision, with 37.8% rating this as not important. There were no differences in motivational factors between male and female applicants. Few applicants felt “very comfortable” performing laparoscopic hysterectomy (16.2%) or laparoscopic myomectomy (3.0%) upon completion of residency training. Conclusion: FMIGS applicants are motivated by their interest in minimally invasive gynecologic surgery, academia and research, and the opportunity to increase their proficiency with advanced endoscopic procedures. Virtual Poster Session 2: Basic Science/Research/Education (1:30 PM − 1:40 PM) 1:30 PM: STATION Q 1711 Cesarean Scar Defect: Risk Factors and Comparison of Evaluation Efficacy between Transvaginal Sonography and Magnetic Resonance Imaging Tang X,1,* Wang J,2 Zhang X,3 Hua K4. 1Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China; 2Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China; 3The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China; 4Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China *Corresponding author. Study Objective: The aim of this study is to determine the risk factors for development of cesarean scar defect (CSD), to compare the efficacy of transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) for CSD assessment, further to investigate the association between CSD size and clinical symptoms. Design: A retrospective cohort study Setting: Obstetrics and Gynecology Hospital of Fudan University Patients or Participants: A total of 189 CSD patients and 378 non-CSD women with a history of cesarean section (CS) in Obsterics and Gynecology Hospital of Fudan University from January 2008 to February 2016 were enrolled.