First Trimester Abortion by Vacuum Aspiration: Interphysician Variability

This study compares the performances of four physicians using two types of plastic cannulae (flexible and rigid) for 1100 vacuum aspiration procedures. The criteria for assessing physician performance by cannula type were: (a) frequency of cannula obstructions, (b) amount of retained tissue obtained by sharp curettage after vacuum aspiration, (c) estimated blood loss during the procedure and (d) time required to perform the procedure. Data for each physician were compared and yielded significantly different results. The length of time required to use the cannula differed significantly among physicians; two of them had significantly shorter cannula times with the flexible instrument. The others had the lowest distributions of blood loss and the most difference between cannula usage. Consistent grouping over several variables suggests that differences in these criteria are more likely to be attributable to subtle distinctions in operator technique than to variations in equipment.