Teaching and training in laparoscopic inguinal hernia repair (TAPP): impact of the learning curve on patient outcome

Abstract

Our study demonstrates that the TAPP learning curve of young trainees is only related to operation time. Therefore, TAPP is a safe and reproducible technique when performed by young trainees under the supervision of experienced laparoscopic surgeons. With an adequate program, the technique can be learned quickly, skillfully, and safely when a standardized technique is used. It should be included as a fundamental part of state-of-the-art trainee programs.

Effectivity of laparoscopic inguinal hernia repair (TAPP) in daily clinical practice: early and long-term result

“…After introduction of TAPP in 1993 by the chief surgeon firstly he trained and supervised the senior residents and the senior residents trained the residents and the trainees. Teaching and learning as it is used in our department has been published by Bökeler et al [12]. Using this systematic training and supervision the results of trainees and residents are not significantly different except for operation time.…”

“…However, the length of learning curve is strictly dependent on both standardization of the technique and the educational program used. In institutions presenting a high case load, a strictly standardized technique and a structured educational program, the number of operations a fellow surgeon needs to gain proficiency may be much smaller and will not exceed 50 repairs [12]. Moreover, it is shown that the results of the surgeons in training are not worse compared to those of experienced hernia surgeons provided that adequate supervision is guaranteed [12].…”

TEP and Lichtenstein anatomy: does simulation accelerate acquisition among interns?

“…This study was the first to report tangible evidence of improved patient outcomes following surgical simulation. Another study by Bökeler et al [16] validates the need for state of the art training programs to teach and train total awareness of laparoscopic inguinal hernia anatomy among GS residents. In this study, trainees were not allowed to perform a laparoscopic hernia repair until they had met specific preoperative requirements that centered on mastery of groin anatomy from the laparoscopic view.…”

The experience and awareness of laparoendoscopic procedures among Polish surgeons in everyday clinical practice.

“…Laparoscopic surgical techniques and endoscopic hernia repair are a part of surgical training offered to registrars in many countries [7]. The outcomes of intensive training based on interactive techniques, surgical simulators and video recording analysis show a lack of differences between the skill level of experienced surgeons, and registrars reveal that the learning curve has been completed [8].…”