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Re: TVT & TOT adviceFrom: Atkinson, Samuel M (ATKINSONS@ECU.EDU)Tue Nov 7 05:59:21 2006
Joanne: The original TVT, passed from the vagina to the abdomen was a daunting and frightening procedure. I began doing them in 1997 and did over 300 until, as I was proctoring someone on his patient , I hit the femoral network. Pt is alive, walks, works, has minimal edema and will be fine when my insurance co settles with her.I do not do them any more. The follow on procedure, the TVT/obturator is safe, has a rare risk of some thigh pain and statistics are better than Burch for cure and longevity and morbidity. It is the most rewarding procedure I have done in my career of 45 years. You cannot not learn it. Preceptorships from AMS and Gynecare are available for both cadaver experience and live scrubbing at some sites depending on liscensing and Malpx ins. Anyone who does an anterior repair, with a course and their certificate should get privileges even in conservative Vt. BTW, I am 71+ and am on the way to the OR after a great microwave of the Prostate 5 days ago. We just have got to stay up to date!!!! sAm -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Joanne Bulley, MD Sent: Tuesday, November 07, 2006 6:55 AM To: Multiple recipients of list OB-GYN-L Subject: TVT & TOT advice Any advice for an older gyn (me) to get trained on the TVT or TOT and bring into a small hospital - where I would need to convince the Med Staff Priveleges folks that I should bring it in to the hospital and know what I am doing? Can I get proctoring on real people cases after doing the training? One problem in a small practice is accumulating enough to do in a few months to be good at it and comfortable with it. Recommendations on or off line would be welcome.
-- Joanne Bulley, MD Keene, NH, USA
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