Microvascular coupling devices: neglected resource with a short learning curve

Single-incision laparoscopic cholecystectomy (SILC) is a recent technical modification on standard laparoscopic cholecystectomy that has been shown to be safe and feasible. Recent studies suggest that experienced laparoscopic surgeons have a short learning curve to become proficient in SILC. However, little is known about the interaction of the learning curves of residents and attending surgeons at academic programs. We prospectively evaluated various metrics of both attending and resident surgeons as they progressed in their experience with SILC. Patients were placed into cohorts of 25 based on teaching surgeon experience. Data recorded included patient-specific and operative variables along with complications, conversion to standard laparoscopic cholecystectomy, and outcomes. One hundred one patients underwent SILC. Twelve per cent of patients required conversion to standard laparoscopic cholecystectomy. No significant difference was found in operative times compared within the experience-based cohorts ( P = 0.21). A reduction in operative time was shown in residents who were proficient in standard laparoscopic cholecystectomy (SLC) along their learning curve. Operative times remained the same for the teaching surgeon regardless of experience of resident surgeon. SILC has a short learning curve for resident surgeons who are proficient in standard laparoscopic surgery. SILC can be effectively taught with few complications and outcomes similar to SLC with preservation of operative efficiency and safety. Further studies are warranted, however, at a national/international level to define the place and use for SILC as well as the incorporation of single-incision techniques into resident curriculum.

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Single-port cholecystectomy: small scar, short learning curve

Surgical Endoscopy ◽

10.1007/s00464-010-1070-6 ◽

2010 ◽

Vol 24 (12) ◽

pp. 2954-2957 ◽

Cited By ~ 81

Author(s):

Daniel Solomon ◽

Robert L. Bell ◽

Andrew J. Duffy ◽

Kurt E. Roberts

Keyword(s):

Learning Curve ◽

Single Port ◽

Short Learning Curve

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OVUM PICK UP (LOPU) IN SANTA INES SHEEP: LEARNING CURVE AND TECHNICAL DETAILS Aspiração folicular ovariana em ovelhas da raça Santa Inês: curva do aprendizado e detalhes técnicos

Revista Acadêmica Ciência Animal ◽

10.7213/academica.011.003.ao03 ◽

2013 ◽

Vol 11 (3) ◽

pp. 235 ◽

Cited By ~ 1

Author(s):

Pedro Paulo Maia Teixeira ◽

Luciana Cristina Padilha ◽

Alanna Do Socorro Lima da Silva ◽

Felipe Farias Pereira da Câmara Barros ◽

Leandro Nassar Coutinho ◽

...

Keyword(s):

Learning Curve ◽

Estrous Cycle ◽

Laparoscopic Approach ◽

Operation Time ◽

Surgical Time ◽

Short Learning Curve ◽

Laparoscopic Procedures ◽

Total Operation Time ◽

Technical Details ◽

Santa Inês

The aim of the current study was to assess the efficacy, the learning curve and associated technical difficulties oflaparoscopic ovum pick-up (LOPU) in sheep. Ten ovum pick-up sessions were performed in six Santa Ines sheep during a cycle of 7-day intervals, totaling 60 laparoscopic procedures. The sheep were managed for synchronizationof the estrous cycle. The laparoscopic approach was carried out using three ports. The number of follicles viewed, aspirated follicles and oocytes recovered were 13.32 ± 2.8, 11.37 ± 2.8 and 6.36 ± 2.0, respectively. Total operation time was used to assess the learning curve among 10 laparoscopic sessions. Mean surgical time was relatively short (26.75 ± 9.6 minutes). Surgical time decreased from the first session on (P < 0.05). LOPU was demonstrated to be a procedure with little intercurrence and with a short learning curve. Others studies regarding this technique should be performed to minimize possible complications and enabling its use in the field

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3D CAD software chosen for its ease of use and short learning curve

Aircraft Engineering and Aerospace Technology ◽

10.1108/aeat.2001.12773aab.025 ◽

2001 ◽

Vol 73 (1) ◽

Keyword(s):

Learning Curve ◽

Ease Of Use ◽

3D Cad ◽

Short Learning Curve

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Impact of Experience on Quality Outcomes in Single-incision Cholecystectomy in Children

The American Surgeon ◽

10.1177/000313481508100913 ◽

2015 ◽

Vol 81 (9) ◽

pp. 839-843 ◽

Cited By ~ 1

Author(s):

Sandra M. Farach ◽

Paul D. Danielson ◽

Ernest K. Amankwah ◽

Nicole M. Chandler

Keyword(s):

Regression Analysis ◽

Learning Curve ◽

Single Incision ◽

Early Group ◽

Quality Outcomes ◽

Surgical Practice ◽

Short Learning Curve ◽

Surgical Trainees ◽

Single Incision Laparoscopic Cholecystectomy ◽

Late Group

Single-incision laparoscopic cholecystectomy (SILC) has been shown to be safe in children; however, factors that impact outcomes are not well understood. We report a retrospective review of 151 patients who underwent SILC between 2009 and 2013. Regression analysis was used to determine inflection of learning curve. Patients were grouped by early cases, late cases, and late case with surgical trainees. Mean age for all patients was 15 ± 3 years (5–20.5 year), and mean weight was 66.5 ± 21.3 kg (15–117 kg). There was a decrease in operative times between the early group (n = 15) and the late group (n = 100) (75.3 vs 56.1 minutes, P < 0.05). Surgical trainees were involved in 36 cases, and their introduction did not significantly increase operative times (56.1 vs 60.4 minutes, P = NS (Non-significant)). No difference in operative times between early cases and cases with trainees was identified (75.3 vs 60.4 minutes, P = NS). The complication was 6 per cent, with no significant differences between the groups. There were five conversions (3.3%). During the adoption of SILC, significantly decreased operative times were achieved after a short learning curve, and these were maintained with surgical trainees. Our results show that SILC can be safely introduced into a pediatric surgical practice.

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Use of Lumen-Apposing Metal Stents (LAMS) in the Management of Gastro Jejunostomy Stricture Following Roux En Y Gastric Bypass for Obesity.

10.21203/rs.3.rs-429795/v1 ◽

2021 ◽

Author(s):

Adam Peter Skidmore

Keyword(s):

Gastric Bypass ◽

Learning Curve ◽

Complete Resolution ◽

High Rate ◽

Pancreatic Pseudocysts ◽

Metal Stents ◽

Efficacy And Safety ◽

X Ray ◽

Short Learning Curve ◽

A Prospective Study

Abstract Background Chronic strictures following Roux en Y Gastric Bypass (RYGB) are a troublesome complication that can lead to significant morbidity. The use of stents has been described but the need for X-ray and risk of migration have meant limited use in the management of these strictures. Lumen apposing metal stents (LAMS) have traditionally been used for management of pancreatic pseudocysts. They don’t require X-ray and are easy to deploy with a short learning curve. This paper explores the use of LAMS to treat post RYGB strictures and explores their safety and efficacy.MethodsA prospective study over a 4-year period looking at 14 patients with post RYGB strictures. These patients have been followed up for between 1 and 3 years. We have prospectively collected data on the efficacy and safety of LAMS in these patientsResults421 patients underwent RYGB in the study period. 14 of these patients developed a stricture that resulted in insertion of LAMS. There was no immediate complications and 12 patients had complete resolution of their stricture. There were no migration related issues.ConclusionLAMS are a safe and effective method to manage post RYGB strictures. They have a high rate of resolution of strictures and can be safely deployed across strictures with no immediate complication. Migration does not appear to be a problem. Insertion is straightforward and doesn’t appear to be associated with a long learning curve.

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