Competence acquisition for single-incision laparoscopic cholecystectomy
Within the past few years, there has been a push for an even more minimally invasive approach to biliary disease with the adoption of single-incision laparoscopic cholecystectomy. We sought to compare 4 individual surgeon experiences to define whether there exists a learning curve for performing sin...
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| Veröffentlicht in: | Journal of the Society of Laparoendoscopic Surgeons 2015-01, Vol.19 (1), p.e2014.00116-e2014.00116 |
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| container_title | Journal of the Society of Laparoendoscopic Surgeons |
| container_volume | 19 |
| creator | Deutsch, Gary B Sathyanarayana, Sandeep Anantha Giangola, Matthew Akerman, Meredith DeNoto, 3rd, George Klein, Jonathan D S Zemon, Harry Rubach, Eugene |
| description | Within the past few years, there has been a push for an even more minimally invasive approach to biliary disease with the adoption of single-incision laparoscopic cholecystectomy. We sought to compare 4 individual surgeon experiences to define whether there exists a learning curve for performing single-incision laparoscopic cholecystectomy.
We performed a retrospective review 290 single-incision laparoscopic cholecystectomies performed by a group of general surgeons, with varying levels of experience and training, at 3 institutions between May 2008 and September 2010. The procedure times were recorded for each single-incision laparoscopic cholecystectomy, ordered chronologically for each surgeon, and subsequently plotted on a graph. The patients were also combined into cohorts of 5 and 10 cases to further evaluate for signs of improvement in operative efficiency.
Of the 4 surgeons involved in the study, only 1 (surgeon 4, laparoscopic fellowship trained with |
| doi_str_mv | 10.4293/JSLS.2014.00116 |
| format | Article |
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We performed a retrospective review 290 single-incision laparoscopic cholecystectomies performed by a group of general surgeons, with varying levels of experience and training, at 3 institutions between May 2008 and September 2010. The procedure times were recorded for each single-incision laparoscopic cholecystectomy, ordered chronologically for each surgeon, and subsequently plotted on a graph. The patients were also combined into cohorts of 5 and 10 cases to further evaluate for signs of improvement in operative efficiency.
Of the 4 surgeons involved in the study, only 1 (surgeon 4, laparoscopic fellowship trained with <5 years' experience) confirmed the presence of a learning curve, reaching proficiency within the first 15 cases performed. The other surgeons had more variable procedure times, which did not show a distinct trend. When we evaluated the cases by cohorts of 5 cases, surgeon 4 had a significant difference between the first and last cohort. Increased body mass index resulted in a slightly longer operative time (P < .0063). The conversion rate to multiport laparoscopic surgery was 3.1%.
Our results indicate that among experienced general surgeons, there does not seem to be a significant learning curve when transitioning from conventional laparoscopic cholecystectomy to single-incision laparoscopic cholecystectomy. The least experienced surgeon in the group, surgeon 4, appeared to reach proficiency after 15 cases. Greater than 5 years of experience in laparoscopic surgery appears to provide surgeons with a sufficient skill set to obviate the need for a single-incision laparoscopic cholecystectomy learning curve.</description><identifier>ISSN: 1086-8089</identifier><identifier>EISSN: 1938-3797</identifier><identifier>DOI: 10.4293/JSLS.2014.00116</identifier><identifier>PMID: 25848190</identifier><language>eng</language><publisher>United States: Society of Laparoendoscopic Surgeons</publisher><subject>Adult ; Cholecystectomy, Laparoscopic ; Clinical Competence ; Female ; Gallbladder Diseases - surgery ; Humans ; Learning Curve ; Male ; Middle Aged ; Operative Time ; Retrospective Studies ; Scientific Papers</subject><ispartof>Journal of the Society of Laparoendoscopic Surgeons, 2015-01, Vol.19 (1), p.e2014.00116-e2014.00116</ispartof><rights>2015 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. 2015 Society of Laparoendoscopic Surgeons, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-255f7df5873c0f67f741e110875f9d6eae160d49a6c559e5f319987ee1ff5b6a3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4379860/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4379860/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,4009,27902,27903,27904,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25848190$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Deutsch, Gary B</creatorcontrib><creatorcontrib>Sathyanarayana, Sandeep Anantha</creatorcontrib><creatorcontrib>Giangola, Matthew</creatorcontrib><creatorcontrib>Akerman, Meredith</creatorcontrib><creatorcontrib>DeNoto, 3rd, George</creatorcontrib><creatorcontrib>Klein, Jonathan D S</creatorcontrib><creatorcontrib>Zemon, Harry</creatorcontrib><creatorcontrib>Rubach, Eugene</creatorcontrib><title>Competence acquisition for single-incision laparoscopic cholecystectomy</title><title>Journal of the Society of Laparoendoscopic Surgeons</title><addtitle>JSLS</addtitle><description>Within the past few years, there has been a push for an even more minimally invasive approach to biliary disease with the adoption of single-incision laparoscopic cholecystectomy. We sought to compare 4 individual surgeon experiences to define whether there exists a learning curve for performing single-incision laparoscopic cholecystectomy.
We performed a retrospective review 290 single-incision laparoscopic cholecystectomies performed by a group of general surgeons, with varying levels of experience and training, at 3 institutions between May 2008 and September 2010. The procedure times were recorded for each single-incision laparoscopic cholecystectomy, ordered chronologically for each surgeon, and subsequently plotted on a graph. The patients were also combined into cohorts of 5 and 10 cases to further evaluate for signs of improvement in operative efficiency.
Of the 4 surgeons involved in the study, only 1 (surgeon 4, laparoscopic fellowship trained with <5 years' experience) confirmed the presence of a learning curve, reaching proficiency within the first 15 cases performed. The other surgeons had more variable procedure times, which did not show a distinct trend. When we evaluated the cases by cohorts of 5 cases, surgeon 4 had a significant difference between the first and last cohort. Increased body mass index resulted in a slightly longer operative time (P < .0063). The conversion rate to multiport laparoscopic surgery was 3.1%.
Our results indicate that among experienced general surgeons, there does not seem to be a significant learning curve when transitioning from conventional laparoscopic cholecystectomy to single-incision laparoscopic cholecystectomy. The least experienced surgeon in the group, surgeon 4, appeared to reach proficiency after 15 cases. Greater than 5 years of experience in laparoscopic surgery appears to provide surgeons with a sufficient skill set to obviate the need for a single-incision laparoscopic cholecystectomy learning curve.</description><subject>Adult</subject><subject>Cholecystectomy, Laparoscopic</subject><subject>Clinical Competence</subject><subject>Female</subject><subject>Gallbladder Diseases - surgery</subject><subject>Humans</subject><subject>Learning Curve</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Operative Time</subject><subject>Retrospective Studies</subject><subject>Scientific Papers</subject><issn>1086-8089</issn><issn>1938-3797</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkE1PAjEQhhujEUXP3gxHLwvtdvt1MTFEUUPiAT03pUyhZne7bBcT_r1FkOhpJjPvvDPzIHRD8LDIFR29zqazYY5JMcSYEH6CLoiiMqNCidOUY8kziaXqocsYPzEuWI7ZOerlTBaSKHyBJuNQNdBBbWFg7Hrjo-98qAcutIPo62UJma9tqqZaaRrThmhD4-3ArkIJdhs7sF2otlfozJkywvUh9tHH0-P7-Dmbvk1exg_TzFJFuyxnzImFY1JQix0XThQESLpTMKcWHAwQjheFMtwypoA5SpSSAoA4x-bc0D663_s2m3kFCwt115pSN62vTLvVwXj9v1P7lV6GL10kJpLjZHB3MGjDegOx05WPFsrS1BA2URMuSJ5jUeRJOtpLbfo6tuCOawjWO_x6h1_v8Osf_Gni9u91R_0vb_oN_sqC7w</recordid><startdate>201501</startdate><enddate>201501</enddate><creator>Deutsch, Gary B</creator><creator>Sathyanarayana, Sandeep Anantha</creator><creator>Giangola, Matthew</creator><creator>Akerman, Meredith</creator><creator>DeNoto, 3rd, George</creator><creator>Klein, Jonathan D S</creator><creator>Zemon, Harry</creator><creator>Rubach, Eugene</creator><general>Society of Laparoendoscopic Surgeons</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201501</creationdate><title>Competence acquisition for single-incision laparoscopic cholecystectomy</title><author>Deutsch, Gary B ; Sathyanarayana, Sandeep Anantha ; Giangola, Matthew ; Akerman, Meredith ; DeNoto, 3rd, George ; Klein, Jonathan D S ; Zemon, Harry ; Rubach, Eugene</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c393t-255f7df5873c0f67f741e110875f9d6eae160d49a6c559e5f319987ee1ff5b6a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Cholecystectomy, Laparoscopic</topic><topic>Clinical Competence</topic><topic>Female</topic><topic>Gallbladder Diseases - surgery</topic><topic>Humans</topic><topic>Learning Curve</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Operative Time</topic><topic>Retrospective Studies</topic><topic>Scientific Papers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Deutsch, Gary B</creatorcontrib><creatorcontrib>Sathyanarayana, Sandeep Anantha</creatorcontrib><creatorcontrib>Giangola, Matthew</creatorcontrib><creatorcontrib>Akerman, Meredith</creatorcontrib><creatorcontrib>DeNoto, 3rd, George</creatorcontrib><creatorcontrib>Klein, Jonathan D S</creatorcontrib><creatorcontrib>Zemon, Harry</creatorcontrib><creatorcontrib>Rubach, Eugene</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of the Society of Laparoendoscopic Surgeons</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Deutsch, Gary B</au><au>Sathyanarayana, Sandeep Anantha</au><au>Giangola, Matthew</au><au>Akerman, Meredith</au><au>DeNoto, 3rd, George</au><au>Klein, Jonathan D S</au><au>Zemon, Harry</au><au>Rubach, Eugene</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Competence acquisition for single-incision laparoscopic cholecystectomy</atitle><jtitle>Journal of the Society of Laparoendoscopic Surgeons</jtitle><addtitle>JSLS</addtitle><date>2015-01</date><risdate>2015</risdate><volume>19</volume><issue>1</issue><spage>e2014.00116</spage><epage>e2014.00116</epage><pages>e2014.00116-e2014.00116</pages><issn>1086-8089</issn><eissn>1938-3797</eissn><abstract>Within the past few years, there has been a push for an even more minimally invasive approach to biliary disease with the adoption of single-incision laparoscopic cholecystectomy. We sought to compare 4 individual surgeon experiences to define whether there exists a learning curve for performing single-incision laparoscopic cholecystectomy.
We performed a retrospective review 290 single-incision laparoscopic cholecystectomies performed by a group of general surgeons, with varying levels of experience and training, at 3 institutions between May 2008 and September 2010. The procedure times were recorded for each single-incision laparoscopic cholecystectomy, ordered chronologically for each surgeon, and subsequently plotted on a graph. The patients were also combined into cohorts of 5 and 10 cases to further evaluate for signs of improvement in operative efficiency.
Of the 4 surgeons involved in the study, only 1 (surgeon 4, laparoscopic fellowship trained with <5 years' experience) confirmed the presence of a learning curve, reaching proficiency within the first 15 cases performed. The other surgeons had more variable procedure times, which did not show a distinct trend. When we evaluated the cases by cohorts of 5 cases, surgeon 4 had a significant difference between the first and last cohort. Increased body mass index resulted in a slightly longer operative time (P < .0063). The conversion rate to multiport laparoscopic surgery was 3.1%.
Our results indicate that among experienced general surgeons, there does not seem to be a significant learning curve when transitioning from conventional laparoscopic cholecystectomy to single-incision laparoscopic cholecystectomy. The least experienced surgeon in the group, surgeon 4, appeared to reach proficiency after 15 cases. Greater than 5 years of experience in laparoscopic surgery appears to provide surgeons with a sufficient skill set to obviate the need for a single-incision laparoscopic cholecystectomy learning curve.</abstract><cop>United States</cop><pub>Society of Laparoendoscopic Surgeons</pub><pmid>25848190</pmid><doi>10.4293/JSLS.2014.00116</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Adult Cholecystectomy, Laparoscopic Clinical Competence Female Gallbladder Diseases - surgery Humans Learning Curve Male Middle Aged Operative Time Retrospective Studies Scientific Papers |
| title | Competence acquisition for single-incision laparoscopic cholecystectomy |
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