Impact of the learning curve on term delivery rates following laparoscopic salpingostomy for infertility associated with distal tubal occlusive disease.

The objective of this study was to determine the impact of the learning curve of one surgeon on the term delivery rate following laparoscopic salpingostomy for tubal infertility. This was a retrospective audit of ongoing clinical practice, undertaken in two tertiary level infertility programmes. Subjects in this study were women undergoing surgery for total occlusion of the distal Fallopian tube. The main outcome measure was cumulative term delivery rates. On stepwise life-table analysis the length of infertility, primary and secondary infertility, tubal diameter and whether surgery was performed in the first or second half of the series were significantly associated with outcome. These data suggest that there is a learning curve in obtaining skills to perform laparoscopic salpingostomy, that patient selection may improve with experience, and that selection criteria should be emphasized during didactic teaching and the preceptorship process.