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Evaluation of the Single-Port Laparoscopic Right Hemicolectomy Learning Curve

机译:单孔腹腔镜右半结肠切除术学习曲线的评估

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Background: The use of single-port laparoscopy has gained popularity within recent years. Part of the appeal in learning this approach is that it draws heavily from concepts mastered through conventional laparoscopy. Various studies have shown the efficacy and feasibility of the single-port laparoscopic approach, but there are few that examine the learning curve in adopting this new technique. Objective: Our goal was to better define the learning curve in performing a single-port laparoscopic right hemicolectomy. Design: A review of prospectively gathered operative data was performed to analyze the results of single-port laparoscopic right hemicolectomies performed within our institution by experienced laparoscopic surgeons. The first 100 cases were divided into quintiles. Comparisons were made among the cohorts regarding patient demographics, operative time, length of stay, conversions, and complications. Results: There was no difference among quintiles with regard to age, sex, BMI, or ASA class. Operative time, conversions, length of stay, and number of complications did not significantly vary among each group of patients. There was a significant difference in estimated blood loss and length of stay between the fifth cohort and the others due to one patient’s poor outcome. Conclusions: The single-port laparoscopic right hemicolectomy learning curve for surgeons already skilled in laparoscopy is short. There are few differences in various outcome measures among groups at any stage in the learning curve. The skills utilized to perform conventional laparoscopic colorectal surgery readily translate to the single-port approach and result in proficiency from nearly the start.
机译:背景:近年来,单端口腹腔镜的使用已普及。学习这种方法的部分吸引力在于,它大量借鉴了通过常规腹腔镜检查掌握的概念。各种研究已经表明了单端口腹腔镜方法的有效性和可行性,但是很少有人研究采用这种新技术的学习曲线。目的:我们的目标是更好地定义执行单端口腹腔镜右半结肠切除术的学习曲线。设计:对前瞻性收集的手术数据进行回顾,以分析由经验丰富的腹腔镜外科医生在我们机构内进行的单端口腹腔镜右半电切开术的结果。前100例分为五等分。在队列中对患者的人口统计学,手术时间,住院时间,转换和并发症进行了比较。结果:五分位数之间在年龄,性别,BMI或ASA类别方面无差异。每组患者的手术时间,转换时间,住院时间和并发症数量均无显着差异。由于一名患者的不良结局,第五队列与其他队列之间的估计失血量和住院时间存在显着差异。结论:对于已经熟练腹腔镜检查的外科医生,单口腹腔镜右半结肠切除术的学习曲线较短。在学习曲线的任何阶段,各组之间的各种结局指标几乎没有差异。用于执行常规腹腔镜大肠直肠手术的技能很容易转化为单端口方法,并且几乎从一开始就可以熟练掌握。

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