Surgical Privileging in Gynecology

Abstract

OBJECTIVES: This study aimed to describe the criteria used by US hospitals to grant surgical privileges for select gynecologic procedures and to compare the privileging processes between university-based and community-based hospitals. METHODS: We conducted a cross-sectional study from January 2011 to December 2012 that included institutions represented by Fellows' Pelvic Research Network members. A 5-page, anonymous survey was distributed to hospitals to determine the hospital criteria used for initial surgical privileges and for renewal of privileges for 13 gynecologic procedures. Information on training requirements, minimum number of supervised cases, and annual case number needed for maintenance was obtained. Criteria for privileging were described and compared between university-based and community-based hospitals. RESULTS: Of the 25 institutions that completed the surveys, 56% were university-based and 44% were community-based. Community hospitals differed significantly from university institutions with a larger portion of community hospitals requiring preceptorship for laparoscopic hysterectomy (70% vs 15%, P = 0.027), robotic hysterectomy (90% vs 25%, P = 0.012), robotic sacrocolpopexy (90% vs 20%, P = 0.009), and sacral neuromodulation (67% vs 0%, P = 0.004). CONCLUSIONS: Considerable variability exists in the criteria used by US hospitals for surgical privileging in gynecology. When compared to university centers, a higher proportion of community hospitals required preceptorship for minimally invasive hysterectomy, robotic sacrocolpopexy, and sacral neuromodulation.