Implementation of French AmbUlatory Cesarean Section (FAUCS): Establishment of a Learning Curve and Short-term Outcomes

Background: The French AmbUlatory Cesarean Section (FAUCS) technique was introduced to the Galilee Medical Cen-ter in September 2021. FAUCS was performed electively for interested women who meet the criteria. Objectives: To evaluate the learning curve of senior surgeons performing FAUCS, the procedure short-term outcomes, and complications. Methods: This retrospective study included 50 consecutive women who underwent FAUCS from September 2021 until March 2022 at our facility. Preoperative, intraoperative, post-operative, and demographic data were retrieved from patient electronic charts. Results: The mean age was 34.2 +/- 5.6 years. The mean duration of surgery was 53.26 +/- 11.62 minutes. This time decreased as the surgical team's experience increased: from a mean 58.26 +/- 12.25 minutes for the first 15 procedures to a mean 51.17 +/- 9.73 min-utes for subsequent procedures. The mean visual analogue scale score for 24 hours was 1.08 +/- 0.84 (on a 10-point scale). The mean time to spontaneous urination after the operation was 6.23 +/- 3.73 hours; 44% of the women were able to mobilize and urinate spon-taneously by 4-6 hours. Complications included bladder injury (n=1), endometritis (n=1), and incisional hematoma (n=1). Overall, the maternal satisfaction rate was high; 94% of the women would recommend FAUCS to others. Conclusions: FAUCS is a feasible procedure with a high satis-faction rate. Following the first 15 procedures performed by one surgical team, the operative time decreased considerably. Further randomized controlled studies are needed to compare this proce-dure to regular cesarean section and evaluate neonatal outcomes.