The Learning Curve of Laparoendoscopic Single-Site (LESS) Cholecystectomy: Definable, Short, and Safe

Hernandez, Jonathan M.; Ross, Sharona; Morton, Connor; McFarlin, Kellie; Dahal, Sujat; Golkar, Farhaad C.; Albrink, Michael; Rosemurgy, Alexander S.

doi:10.1016/j.jamcollsurg.2010.07.008

Cited by 72 publications

(56 citation statements)

References 18 publications

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“…Moreover, these methods are difficult to master, need special equipment along with specially trained paramedical staff. (5,7) Enhanced expenses of treatment is another factor. Surgeons who recently mastered classical LC technique will not easily resort to newer ones mere for the sake of cosmetic benefit which is not as appealing.…”

Section: Resultsmentioning

confidence: 99%

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Newer Technique of Gall Bladder Removal: Are They Worth?

Randhawa¹,

Singh²,

Bajwa³

2014

jemds

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This study includes the works of various surgeons who adopted newer methods of gall bladder removal vis a vis standard method of laparoscopic cholecystectomy through 4-ports. Newer methods include Single-incision laparoscopic cholecystectomy (SILC) and Natural Orifice Transluminal Endoscopic Surgery (NOTES). The work of various studies of Laparoscopic Cholecystectomy (LC), a gold standard so far analysed against the newer techniques with respect to complications directly related to the procedure such as biliary injury, bile leak, infection, trochar related injury and post-operative incisional hernia; Post-operative hospital stay and return to work and expenses incurred over the surgical procedure .Laparoscopic cholecystectomy 4-port standard procedure, still rules the roost. Newer methods like SILC and NOTES though around for more than 8 yrs but yet to click with surgeons and more importantly with patients. Patients still find the 4-port LC fine and satisfied with it. Laparoscopic cholecystectomy (4-port LC) continues to be the method of choice with surgeons throughout globe except in few pockets. It has been standardized for procedure details and rate of complications and conversions .Till now apart from some extra advantage of cosmetic superiority newer methods do not provide any extra advantage as far as complications, hospital stay, return to normal activity and treatment cost are concerned.

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Section: Resultsmentioning

confidence: 99%

“…(2) Now about 8yrs back two newer methods of gall bladder removal are introduced to challenge the now gold standard 4-port LC adopted across the globe. (3,4,5) Many studies(about50) are found on these newer methods. (6,7,8) Most studies done over small number of patients.…”

Section: Introductionmentioning

confidence: 99%

Newer Technique of Gall Bladder Removal: Are They Worth?

Randhawa¹,

Singh²,

Bajwa³

2014

jemds

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“…With the increasing presence of single-port laparoscopy within surgical practice, it is important to understand how long it takes a surgeon to become facile with this evolving approach. Prior studies have already examined the learning curve for various single-port laparoscopic operations [7][8][9], and have concluded that the learning curve is fairly short for those already experienced in their field. However, this is the first report examining the learning curve with regards to colorectal surgery.…”

Section: Discussionmentioning

confidence: 99%

“…There has been some data addressing the learning curve for single-port laparoscopic cholecystectomy, gastric band placement, and nephrectomy [7][8][9]. However, there have been no studies looking at the learning curve for performing any single-port laparoscopic colorectal surgeries.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Single-Port Laparoscopic Right Hemicolectomy Learning Curve

George¹,

Guzman²,

Waters³

et al. 2013

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Background: The use of single-port laparoscopy has gained popularity within recent years. Part of the appeal in learning this approach is that it draws heavily from concepts mastered through conventional laparoscopy. Various studies have shown the efficacy and feasibility of the single-port laparoscopic approach, but there are few that examine the learning curve in adopting this new technique. Objective: Our goal was to better define the learning curve in performing a single-port laparoscopic right hemicolectomy. Design: A review of prospectively gathered operative data was performed to analyze the results of single-port laparoscopic right hemicolectomies performed within our institution by experienced laparoscopic surgeons. The first 100 cases were divided into quintiles. Comparisons were made among the cohorts regarding patient demographics, operative time, length of stay, conversions, and complications. Results: There was no difference among quintiles with regard to age, sex, BMI, or ASA class. Operative time, conversions, length of stay, and number of complications did not significantly vary among each group of patients. There was a significant difference in estimated blood loss and length of stay between the fifth cohort and the others due to one patient's poor outcome. Conclusions: The single-port laparoscopic right hemicolectomy learning curve for surgeons already skilled in laparoscopy is short. There are few differences in various outcome measures among groups at any stage in the learning curve. The skills utilized to perform conventional laparoscopic colorectal surgery readily translate to the single-port approach and result in proficiency from nearly the start.

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“…The learning curve of the SILS procedures has not been described in patients with Crohn's disease. However, in SILS cholecystecomies and SILS ileocolic resections, several studies showed that the learning curve does not include the slow beginning and steep acceleration seen in standard multi-incision laparoscopy [27,36,37]. In SILS colectomy, a minimal learning curve in experienced laparoscopic surgeons is described [28,38].…”

Section: Single-incision Laparoscopic Surgerymentioning

confidence: 99%

Surgery for Crohns Disease: New Developments

Gardenbroek

Tanis²,

Buskens³

et al. 2012

Dig Surg

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Background/Aims: Crohn’s disease is a chronic relapsing inflammatory bowel disease requiring surgery in a large number of patients. This review describes new developments in surgical techniques for treating Crohn’s disease. Results: Single-incision laparoscopic surgery decreases abdominal wall trauma by reducing the number of abdominal incisions, possibly improving postoperative results in terms of pain and cosmetics. The resected specimen can be extracted through the single-incision site or the future stoma site. Another option is to use natural orifices for extraction (i.e. transcolonic/transanal), but actual benefits of these procedures have not yet been determined. In patients with extensive perianal disease or rectal involvement, transperineal completion proctectomy is often feasible, thereby avoiding relaparotomy. By using a close rectal intersphincteric resection, damage to the pelvic autonomic nerves is avoided. In addition, the risk of presacral abscess formation is reduced by leaving the mesorectal tissue behind. Conclusion: Minimally invasive surgery and associated techniques have become standard clinical practice in surgical treatment of patients with Crohn’s disease. New developments aim at further reducing the hospital stay and morbidity, and improving the cosmetic outcomes.

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The Learning Curve of Laparoendoscopic Single-Site (LESS) Cholecystectomy: Definable, Short, and Safe

Cited by 72 publications

References 18 publications

Newer Technique of Gall Bladder Removal: Are They Worth?

Newer Technique of Gall Bladder Removal: Are They Worth?

Evaluation of the Single-Port Laparoscopic Right Hemicolectomy Learning Curve

Surgery for Crohns Disease: New Developments

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The Learning Curve of Laparoendoscopic Single-Site (LESS) Cholecystectomy: Definable, Short, and Safe

Cited by 72 publications

References 18 publications

Newer Technique of Gall Bladder Removal: Are They Worth?

Newer Technique of Gall Bladder Removal: Are They Worth?

Evaluation of the Single-Port Laparoscopic Right Hemicolectomy Learning Curve

Surgery for Crohns Disease: New Developments

Contact Info

Product

Resources

About

Surgery for Crohns Disease: New Developments