No extensive experience in open procedures is needed to learn lobectomy by video-assisted thoracic surgery

Abstract

With thorough preparation of trainees and training on selected patients under close supervision, the learning curve can be overcome with good results even if the trainee has limited prior experience in open surgery.

Video-assisted thoracoscopic surgery lobectomy for lung cancer is associated with a lower 30-day morbidity compared with lobectomy by thoracotomy

“…This indicates that VATS has not gained a widespread acceptance amongst surgeons. It could be due to a long learning curve, perceived longer operation time or lack of experience in management of intraoperative complications [10,18]. The fact that many studies are conducted at high-volume teaching hospitals may make surgeons at rural hospitals question the generalizability of these studies, and therefore hesitate to choose the VATS procedure.…”

Video-assisted thoracoscopic lobectomy: which is the learning curve of an experienced consultant?

“…There is a bulk of data describing and defining the learning curve of surgical trainees without significant experience with open lobectomy, starting to learn VATS lobectomy from scratch. Konge et al showed that the learning curve can be overcome with good results, even if the beginner surgeon has limited prior experience in open surgery (19).…”

“…In the past, many studies have analysed the learning curve for different surgical techniques (12,(19)(20)(21)(22)(23)(24). Generally speaking, a learning curve is considered to have been overcome when the monitored outcome indicators reach a steady state (20).…”

VATS lobectomy program: the trainee perspective

“…However, whether or not prefer teaching VATS lobectomies to senior trainees with or without experience in traditional open lobectomy has been matter of discussion in several papers (13)(14)(15). According to those papers, VATS lobectomy remains a safe procedure, even if performed despite limited experience in open lobectomy, and affirm that the previous surgical training has a minimal impact on operative and postoperative outcomes (surgery time, blood loss, conversion rate, chest tube duration, postoperative morbidity and mortality).…”