Competency in laparoscopic colorectal surgery is achievable with appropriate training but takes time: a comparison of 300 elective resections with anastomosis

Dalton, S. J.; Ghosh, Alip; Zafar, N.; Riyad, Kallingal; Dixon, A. R.

doi:10.1111/j.1463-1318.2009.01998.x

Cited by 16 publications

(19 citation statements)

References 29 publications

(31 reference statements)

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“…Furthermore, the series was unselected to include 'all comers'. We have previously shown no increase in morbidity or mortality in these cases [26], suggesting that in a high-volume centre, senior trainees can gain adequate laparoscopic skills and reach competency relatively quickly.…”

Section: Discussionmentioning

confidence: 66%

Laparoscopic colorectal surgery - why would you not want to have it and, more importantly, not be trained in it? A consecutive series of 500 elective resections with anastomoses

et al. 2011

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Section: Discussionmentioning

confidence: 66%

Laparoscopic colorectal surgery - why would you not want to have it and, more importantly, not be trained in it? A consecutive series of 500 elective resections with anastomoses

et al. 2011

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“…Borowski et al 12 Chester and Britton 15 Costantino et al 29 Dalton et al 17 Hawkins et al 21 Hilska et al 19 Isbister 13 Khan et al 30 Krishna et al 16 Langhoff et al 23 Li et al 14 Pastor et al 22 Renwick et al 18 Singh and Aitken 25 Tytherleigh et al 24 Verheijen et al 26 Total Heterogeneity:…”

Section: Referencementioning

confidence: 99%

Systematic review and meta-analysis of trainee- versus expert surgeon-performed colorectal resection

Kelly

Bhangu

Singh

et al. 2014

British Journal of Surgery

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“…Though literature on the influence of trainee involvement on clinical outcomes is mixed, numerous studies have reported increases in operative duration secondary to trainee participation. (7–10) And recent studies of laparoscopic gastric bypass suggest that differences in the technique used to construct the gastrojejunostomy can have dramatic effects on postoperative outcomes. (11) …”

Section: Introductionmentioning

confidence: 99%

Influence of median surgeon operative duration on adverse outcomes in bariatric surgery

Reames

Bacal

Krell

et al. 2015

Surgery for Obesity and Related Diseases

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Background Evidence suggests that prolonged operative time adversely affects surgical outcomes. However, whether faster surgeons have better outcomes is unclear, as a surgeon’s speed could reflect skill and efficiency, but may alternatively reflect haste. Objectives This study evaluates whether median surgeon operative time is associated with adverse surgical outcomes following laparoscopic Roux-en-Y gastric bypass. Methods We performed a retrospective cohort study using statewide clinical registry data from the years 2006 to 2012. Surgeons were ranked by their median operative time and grouped into terciles. Multivariable logistic regression with robust standard errors was used to evaluate the influence of median surgeon operative time on 30-day surgical outcomes, adjusting for patient and surgeon characteristics, trainee involvement, concurrent procedures, and the complex interaction between these variables. Results A total of 16,344 patients underwent surgery during the study period. Compared to surgeons in the fastest tercile, slow surgeons required 53 additional minutes to complete a gastric bypass procedure [median (Interquartile range) 139 (133–150) vs. 86 (69–91), p<0.001]. After adjustment for patient characteristics only, slow surgeons had significantly higher adjusted rates of any complication, prolonged length of stay, ED visits or readmissions, and venous thromboembolism (VTE). After further adjustment for surgeon characteristics, resident involvement, and the interaction between these variables, slow surgeons had higher rates of any complication (10.5% vs. 7.1%, p=0.039), prolonged length of stay (14.0% vs. 4.4%, p=0.002), and VTE (0.39% vs. 0.22%, p<0.001). Conclusions Median surgeon operative duration is independently associated with adjusted rates of certain adverse outcomes following laparoscopic Roux-en-Y gastric bypass. Improving surgeon efficiency while operating may reduce operative time and improve the safety of bariatric surgery.

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Competency in laparoscopic colorectal surgery is achievable with appropriate training but takes time: a comparison of 300 elective resections with anastomosis

Cited by 16 publications

References 29 publications

Laparoscopic colorectal surgery - why would you not want to have it and, more importantly, not be trained in it? A consecutive series of 500 elective resections with anastomoses

Laparoscopic colorectal surgery - why would you not want to have it and, more importantly, not be trained in it? A consecutive series of 500 elective resections with anastomoses

Systematic review and meta-analysis of trainee- versus expert surgeon-performed colorectal resection

Influence of median surgeon operative duration on adverse outcomes in bariatric surgery

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