Erdem GÜRKAN, Gökçenur KARAKELLEOĞLU, Ayşe Gülen ERTURUN, Erhan Hüseyin CÖMERT
Anatolian Journal of Obstetrics and Gynecology Research - 2026;3(1):33-38
Purpose: To evaluate the learning curve of labium majora plasty using the learning curve cumulative summation (LC-CUSUM) method and to determine the number of procedures required to achieve surgical proficiency. Methods: This retrospective study analyzed 120 consecutive labium majora plasty procedures performed by three obstetrics and gynecology specialists with no prior experience in cosmetic gynecology. All trainees completed a standardized hands-on training course before independently performing procedures in their own clinics. Each trainee's first 40 cases were evaluated. Surgical success and failure were defined based on postoperative complications, need for revision, and patient dissatisfaction. LC-CUSUM analysis was applied using predefined acceptable (3%) and unacceptable (10%) failure rates. Continuous variables were analyzed using analysis of variance, and categorical variables using chi-square or Fisher's exact test. Results: A total of 120 patients were included (40 per trainee). Patient demographics and procedural characteristics were comparable among the three groups (p>0.05). Failure rates were 5% (n=2), 7.5% (n=3), and 5% (n=2) for trainees 1, 2, and 3, respectively. LC-CUSUM analysis demonstrated that all trainees achieved acceptable performance levels within the study period. Competency thresholds were reached after 9, 21, and 16 procedures for trainees 1, 2, and 3, respectively. Conclusion: Patient demographics, procedure characteristics, and outcome measures were comparable among the three trainees. LC-CUSUM charts demonstrated that all trainees achieved adequate performance levels during the observation period. Competency thresholds were reached after 9, 21, and 16 procedures for the three trainees indicating variability in individual learning curves.
