Critical appraisal of learning curve for single incision laparoscopic right colectomy

Haas, Eric M.; Nieto, Javier; Ragupathi, Madhu; Aminian, Ali; Patel, Chirag B.

doi:10.1007/s00464-013-3096-z

Cited by 37 publications

(25 citation statements)

References 11 publications

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“…Haas et al evaluated the learning curve for single-incision right colectomy in 54 consecutive patients over a 2-year period, and identified the achievement of the learning phase between 30 and 36 cases, which corroborates our findings of optimization of operative time after the first 40 cases [40]. Supporting our findings, Haas et al also failed to identify any increased conversion rate, length of stay, or post-operative morbidity during the early phases of the learning curve [40]. Hopping and Bardakcioglu noted decreased estimated blood loss and length of stay over their 20-case series [39].…”

Section: Discussionsupporting

confidence: 86%

“…In accord with the early improvement in operative time demonstrated after 10 cases, Hopping and Bardakcioglu demonstrated decreased operative time after 10 cases in their series of 20 consecutive single-incision right colectomies [39]. Haas et al evaluated the learning curve for single-incision right colectomy in 54 consecutive patients over a 2-year period, and identified the achievement of the learning phase between 30 and 36 cases, which corroborates our findings of optimization of operative time after the first 40 cases [40]. Supporting our findings, Haas et al also failed to identify any increased conversion rate, length of stay, or post-operative morbidity during the early phases of the learning curve [40].…”

Section: Discussionsupporting

confidence: 84%

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Analysis of outcomes for single-incision laparoscopic surgery (SILS) right colectomy reveals a minimal learning curve

et al. 2014

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Analysis of our large series of consecutive cases indicates that for a surgeon trained in advanced laparoscopic techniques and given adequate case volume, the outcomes from the procedure are quickly optimized with a minimal learning curve. Operative time is optimized following 40 procedures. Identification of the learning curve is critical for surgeons wishing to implement a single-incision approach and to ensure that the outcomes are optimized prior to thorough comparison with standard laparoscopic or open approaches.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 84%

Analysis of outcomes for single-incision laparoscopic surgery (SILS) right colectomy reveals a minimal learning curve

et al. 2014

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“…A single death also occurred in the study from Velthuis et al [27], caused by patient's significant comorbidities, while Keshava et al [32] also reported on a single perioperative death caused by neutropenic sepsis. Haas et al [31] also reported on a single death on the third postoperative day, caused by respiratory failure in the setting of pulmonary metastasis. Only the single death reported by Waters et al [20] was firmly associated with the surgical technique of SIL-RH, rendering SIL-RH a safe surgical operation.…”

Section: Postoperative Outcomesmentioning

confidence: 97%

Single-Incision Laparoscopic Right Hemi-Colectomy: a Systematic Review

Αποστόλου

Orfanos²,

Papalois

et al. 2015

Indian J Surg

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As surgeons became more adept with laparoscopic colon surgery, other less invasive procedures, such as singleincision laparoscopic right hemi-colectomy (SIL-RH), have been applied. The objective of this study was to evaluate the safety of SIL-RH as well as its intraoperative and postoperative outcomes for right-sided colon diseases. A detailed search in PubMed for citations that included SIL-RH from 2000 to 2014 revealed 21 studies fulfilling the criteria of the present review. A total of 684 patients were analyzed. Of the patients, 50.2 % were men. Mean patient age was 64.8 years. Of the patients, 36.1 % had already undergone an abdominal operation before the performance of SIL-RH, while 69 % of the patients underwent SIL-RH for colon cancer. Relatively low rates of overall morbidity (15 %) and mortality (0.75 %) were reported in the included studies. Mean length of postoperative hospital stay (LOS) was 5.5 days. Bowel motility return had a mean value of 2.8 days. Mean number of harvested lymph nodes (LN) was 19.2 LN. All resection margins were tumorfree. SIL-RH was a safe alternative to multiport laparoscopic right hemi-colectomy (ML-RH) in terms of morbidity and mortality, postoperative gastrointestinal function recovery, LOS, as well as oncological radicalness.

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“…In a series of 54 consecutive SILCs which were done, Haas EM et al, [27] concluded that SILCs didn't result in increased complications or harmful results, even in the early phase of the learning curve. A prospective case series of eleven patients (seven men and four women) who underwent single incision multiport laparoscopic colorectal resections for malignancies by using conventional laparoscopic trocars and instruments, has been described by Palanivelu C et al, [13].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Colorectal Surgery: An Update (with Special Reference to Indian Scenario)

Moirangthem¹

2014

JCDR

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Laparoscopic cholecystectomy, being already declared as gold standard technique, laparoscopic surgery has advanced far and wide, touching almost every corner of the abdomen. This advancement has gradually expanded to colorectal surgery which is done for malignant diseases as well. However, laparoscopic colorectal surgery has not been accepted as quickly as was laparoscopic cholecystectomy. This is because of its steep learning curve, concerns with oncological outcomes, lack of randomized control trials (RCTs) and initial reports on high port site recurrences which occurred after curative resections. But all these initial concerns have been overcome by doing a series of RCTs globally, in the past decade, that revealed that laparoscopic colorectal surgery for malignant disease offered short term benefits without compromising on oncological principles of radicality of resection, tumour resection margins and completeness of lymph node harvesting as compared to those of open surgery. Favourable post-operative results with respect to less blood loss, less pain, lesser surgical site infections, lesser requirement of analgesics, early return of bowel function and shorter hospital stay in patients who underwent laparoscopic colorectal resections were obtained in studies done on individual series, including those done in India and more recently, in large trials. An update on recent studies done on laparoscopic colorectal surgery by reviewing many RCTs and individual series, including our experiences, was made, to support the advantages of this procedure which were obtained when it was carried out by skilled hands.

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Critical appraisal of learning curve for single incision laparoscopic right colectomy

Abstract: In our experience, the learning curve is achieved between 30 to 36 cases. Offering this minimally invasive surgical approach does not result in increased complications or harmful results even in the early phases of the learning curve.

Cited by 37 publications

References 11 publications

Analysis of outcomes for single-incision laparoscopic surgery (SILS) right colectomy reveals a minimal learning curve

Analysis of outcomes for single-incision laparoscopic surgery (SILS) right colectomy reveals a minimal learning curve

Single-Incision Laparoscopic Right Hemi-Colectomy: a Systematic Review

Laparoscopic Colorectal Surgery: An Update (with Special Reference to Indian Scenario)

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