(Poster 84) Clocking the Colpopexy? Benchmarking Operative Time for Sacrocolpopexy

Objectives: To define expected operative times for sacrocolpopexy with and without concurrent hysterectomy and explore how these data can be used to support surgical benchmarking and inform assessments of operative efficiency and competency.

Methods: We conducted a retrospective analysis of patients who underwent minimally invasive sacrocolpopexy using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). Cases were stratified by the presence of concurrent hysterectomy. The primary outcome was total operative time in minutes. Median operative times were compared using the Wilcoxon rank-sum test.

Results: A total of 14,128 sacrocolpopexy cases were identified, of which 10,799 (76.4%) included a concurrent hysterectomy and 3,329 (23.6%) did not. The median operative time was significantly longer for patients undergoing concurrent hysterectomy compared to those who did not (175.0 vs. 166.0 minutes; p < 0.001). Operative time distributions were right-skewed in both groups, with wider variability in the hysterectomy cohort. The 75th percentile was 231.0 minutes (with hysterectomy) and 216.0 minutes (without), and the 95th percentile reached 329.0 and 310.0 minutes, respectively.

Conclusions: Concurrent hysterectomy is associated with a statistically significant increase in operative time for sacrocolpopexy. While the median difference is modest, the broader spread among hysterectomy cases suggests greater variability and complexity. These data provide useful benchmarks for surgeons and institutions to evaluate individual performance, support competency-based assessment in training, and guide preoperative planning and resource allocation.