When can I be proficient in laparoscopic surgery? A systematic review of the evidence

Dagash, Haitham; Chowdhury, Moti; Pierro, Agostino

doi:10.1016/jpsu.2003.50192

Cited by 126 publications

(105 citation statements)

References 36 publications

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“…Reports of learning curves in surgery abound in selected areas; laparoscopic procedures have been studied in great detail, as they incorporate newer technology for surgeons who have long since left residency [19]. While not agreeing on a specific number of cases necessary for proficiency in a procedure such as laparoscopic cholecystectomy, the studies all support the notion that with increased experience there is a decrease in operative time, conversion rate and complication rate.…”

Section: Discussionmentioning

confidence: 99%

The ‘learning curve’ in hypospadias surgery

Horowitz¹,

Salzhauer

2006

BJU International

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OBJECTIVETo provide an insight into the 'learning curve' of fellowship-trained paediatric urologists associated with hypospadias repair, as hypospadias surgery is one of the most common yet difficult procedures used by the paediatric urologist. PATIENTS AND METHODSProspective data were collected on 231 consecutive hypospadias operations performed by one paediatric urologist (M.H.) over a 5-year period, beginning with his first year after completing his fellowship. All patients were having their first surgery and none had a staged repair. Fistula formation was used as a surrogate for the complication rate, as it is an objective measurable outcome that is easily identified with little interobserver or parental/physician variability. The follow-up included several visits in the 15 months after repair, during which virtually all complications could be identified and addressed. RESULTSThe operative results improved throughout the 5 years of observation; there was a statistically significant decline in the fistula rate in each year of observation ( P < 0.001; Kruskal-Wallis exact test for ranked groups). The absolute reduction in fistula rates between the first 2 and the last 2 years was 12.7% ( P < 0.02; chi squared). CONCLUSIONSThe science and surgery of hypospadiology is mostly and correctly delegated to the paediatric urologist. Even in the hands of a fellowship-trained paediatric urologist, a successful repair, as measured by complication rate, statistically improves with time and experience.

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Section: Discussionmentioning

confidence: 99%

The ‘learning curve’ in hypospadias surgery

Horowitz¹,

Salzhauer

2006

BJU International

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“…Proficiency of a conventional laparoscopic fundoplication is said to be reached after 28 procedures. The variability in operating time remains high for this procedure even in the late phase of surgical experience (Dagash et al 2003). Most advantage of a robotic system is expected in advanced or complicated operative procedures.…”

Section: Wwwintechopencommentioning

confidence: 99%

The Learning Curve of Robot-Assisted Laparoscopic Surgery

Olthof¹,

Nio²,

Bemelman³

2008

Medical Robotics

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“…Performing a threshold number of cases necessary for achieving competency has been suggested for a variety of surgical types, including laparoscopic and colorectal surgery. 15,23,24 Perhaps fellowship types differ in terms of exposure and the number of hepatic resections a fellow performs during training. With the implementation of workhour regulations for residents across North America, exposure to hepatobiliary cases during residency is limited.…”

Section: Discussionmentioning

confidence: 99%