Live surgical demonstrations for minimally invasive colorectal training

Ünal, Umut; Esen, Eren; Yilmaz, Bengi Su; Aytaç, Erman; Bilgin, İsmail Ahmet; Özben, Volkan; Ozoran, Emre; Ağcaoğlu, Orhan; Balık, Emre; Baca, Bilgi; Hamzaoğlu, İsmail; Karahasanoğlu, Tayfun; Buğra, Dursun

doi:10.1007/s00423-020-01858-3

Cited by 4 publications

(1 citation statement)

References 23 publications

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“…Another case series including 107 patients managed mainly for bariatric surgery during 10 consecutive years in live surgery courses organized in Spain, revealed a higher complication rate when compared with that following conventional surgery 34 . In a further single center comparative study, a higher overall complication rate was found for 39 patients managed by minimally invasive colorectal surgery broadcast live when matched with 39 controls 35 . The suggested higher risk of complications associated with live surgery has led several surgical societies to discourage or stop live surgery by visiting surgeons 4,5 …”

Section: Discussionmentioning

confidence: 92%

Live surgery of colorectal endometriosis broadcasted from a surgeon’s routine operating theater is not associated with higher complications rate

Roman

Prosszer²,

Marabha³

et al. 2021

Acta Obstet Gynecol Scand

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Introduction Although live surgeries are routinely included in surgical congress programs, they are the subject of an ongoing debate in terms of patient safety and teaching value. The goal of our study was to assess the risk of postoperative complications related to live surgery broadcast from the surgeon's routine theater, in patients managed for deep endometriosis infiltrating the digestive tract. Material and methods We report a retrospective comparative study, enrolling women managed for colorectal endometriosis by a gynecologic surgeon, from September 2013 to March 2020 in two referral centers. We compared the rate of postoperative bowel fistula in women managed during live surgery in the routine operating theater, with that observed in women for whom surgery was not broadcast. Results Among 813 women, 33 (4.1% of cases) underwent surgical procedures transmitted live to various conference rooms located outside the hospital and were compared with 780 patients who underwent non‐broadcast surgery. Women's age, body mass index, past surgical and obstetrical history, and major preoperative complaints were comparable. Cases presented with impaired constipation score, more frequent sciatic pain, and infiltration of the vagina, whereas overall revised American Fertility Society classification scores were more severe in controls. The rate of rectal nodules over 3 cm in size was comparable between the two groups (72.7% in cases vs. 72.1% in controls). Operative time was also comparable (153 ± 52 minutes vs. 148 ± 79 minutes). Cases were more frequently managed by disk excision of rectal nodules (63.7% vs. 30.3%), and more frequently involved the sacral plexus (18.2% vs. 7.3%). Postoperative complications were comparable between the two groups, in terms of bowel fistula (3% in the live surgery group vs. 4.1% in controls), pelvic abscess requiring secondary laparoscopy (3% vs. 4.9%), or bladder dysfunction requiring self‐catheterization after discharge (6.1% vs. 5.3%). Conclusions Performing laparoscopic management of colorectal endometriosis with live transmission of surgery from a surgeon's routine operating theater, is not related to a higher risk of major postoperative complications.

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Section: Discussionmentioning

confidence: 92%