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

Abstract

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.

Multidimensional analyses of the learning curve for single‐incision plus one port laparoscopic surgery for sigmoid colon and upper rectal cancer

“…Kim et al analyzed 113 cases and reported that the LC for SILAR was 61‐65 cases and the overall operating time was 154 ± 32.0 min, which were both longer than that in our study (44 cases and 98.2 ± 24.8 mins). Previous studies suggested the LC of SILS for colorectal cancer was the 6th‐67th case . Our study indicated that after the 13th case, the learning process reached the plateau period and technical competence was achieved after the 44th case.…”

“…OT is one of the most common factors for determining the LC for surgical procedures. [25][26][27][28][29] According to the results in Figure 2, we suggested that the CUSUM of OT decreased gradually after 33 cases as the surgeon's experience expanded.…”

Learning Curve for Single-Incision Laparoscopic Anterior Resection for Sigmoid Colon Cancer

“…Hopping and Bardakcioglu 13 reported that the LC for SILS right hemicolectomy was 10 cases, and Kirk and colleagues 14 suggested that it was 40 cases. However, both of these studies based their results on differences in OT without using multidimensional statistical techniques.…”

“…There are no published reports about the LC for single-incision laparoscopic anterior resection (SILAR), although there have been a few previous reports about the LC for SILS right hemicolectomy. [13][14][15] The aim of this study was to investigate the LC for SILAR for sigmoid colon cancer using the following statistical methods: moving average method, cumulative sum control chart (CUSUM), and risk-adjusted (RA) CUSUM.…”

Is there a place for single laparoscopic approach in colic surgery?

“…По данным разных авторов, для овладения ме-тодикой операции из ЕЛД опытному лапароскопи-ческому хирургу необходимо выполнить от 30 до 40 вмешательств, после чего оптимизируется время операции, а также снижается частота осложнений и объем кровопотери [7,10].…”