Most gynaecological surgeons appear to do minimal surgery

In the last few weeks alone I have seen 3 patients who have had “failed” surgery. That is the surgeon was unable to complete the planned surgical procedure. I am quite sure this relates to surgical experience and training. The most recent Australian and New Zealand Journal of Obstetrics and Gynaecology dated August 2022 contains a disturbing article about the state of gynaecological surgery within Australia. I have previously commented about the problems associated with low volume surgeons into other blogs, here and here. It appears the situation continues to deteriorate with an increasing number of specialists providing surgical care for a stable if not decreasing number of procedures. In recent years 3 new O & G specialists replace each retirement. This has resulted in a situation outlined in the article by McCormick et al that there are some 2066 Fellows within Australia, of whom 1698 (82.2%) perform operative gynaecology. When the number of procedures are counted the average gynaecological surgeon performed a woeful 4.3 hysterectomies per year and 11.2 laparoscopies. These numbers are so low they should raise considerable alarm within the general community. Imagine the uproar if an obstetrician only performed four Caesareans per year. For most surgical procedures repetition is required to maintain standards. Published articles have revealed that somewhere between 12-20 procedures is the bare minimum required to maintain competence. It is blindingly obvious, clear common sense and backed by multiple studies that low volume surgeons have increased rates of patient morbidity and mortality.
For the record in my career I have performed 669 hysterectomies including 47 in the last 12 months.
The situation is so dire it is an ethical dilemma. My suggestion is that you ask your surgeon how many procedures they have done and if they have a significant obstetric practice be wary of their surgical skill.