Telemedicine Facilitates Surgical Training in Placenta Accreta Spectrum

Int J Gynaecol Obstet. 2021 Oct 29. doi: 10.1002/ijgo.14000. Online ahead of print.

ABSTRACT

OBJECTIVE: The training of groups responsible for managing patients with placenta accreta spectrum (PAS) is complex because of the lack of hospitals with a high flow of patients and absence of formal educational programs. We report the results of a virtual training program (VTP) that implement one-step conservative surgery (OSCS).

METHODS: A prospective observation study of OSCS VTP between three expert groups and PAS reference hospitals without experience in OSCS was performed. Accessible or cost-efficient web meeting platforms were used to implement the VTP components: baseline observation of the participant's prior knowledge; instructions about essential PAS surgery topics; base selection and joint planning of surgery; expert group "telepresence" during surgery and postoperative debriefing.

RESULTS: OSCS was performed successfully at 6 hospitals. All patients had increta/percreta with a median intraoperative bleeding of 1300 mL (IQR 825-2325) and surgical time of 184 minutes (IQR 113-240). All groups considered the VTP very useful (n=33, 97%) or useful (n=1, 3%), they would use it again (definitely: n=27, 81.8%; or probably: n=6, 18.2%), and they would recommend it to other colleagues.

CONCLUSION: Tele education and telepresence during PAS surgery facilitates the implementation of OSCS in selected cases.

PMID:34714947 | DOI:10.1002/ijgo.14000