Corrigendum to “Impact of laparoscopic sacrocolpopexy learning curve on operative time, perioperative complications and short term results” [Eur. J. Obstet. Gynecol. Reprod. Biol. 191 (2015) 84–89]

ntroduction: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most common treatments for morbid obesity. The learning curve for this procedure is 50–75 cases for an independent surgeon, and it is considered the most important factor in decreasing complications and mortality. We present our experience and learning curve with LRYGB for a newly established bariatric center in Poland. Material and methods: A prospectively collected database containing 285 LRYGB procedures performed in the II Department of General Surgery of the Jagiellonian University MC in Krakow between 06.2010 and 03.2019 was retrospectively reviewed. Patients were divided into groups of 30 (G1–G10) in the order of the procedures performed by each surgeon. The study analyzed the course of the operation and patient hospitalization, comparing those groups. Learning curve for the newly created bariatric center was established. Results: Operative time in G1–G3 differed significantly from G4–G10 (P < 0.0001). The stabilization point was the 90th procedure. Perioperative complications were observed in 36 (12.63%) patients. Perioperative complications, intraoperative difficulties and adverse events did not differ importantly among groups. Liberal use of “conversions of the operator” from a surgeon to a senior surgeon provides reasonable safety and prevents complications. Conclusions: The institutional learning process stabilization point for LRYGB in a newly established bariatric center is around the 90th operation. LRYGB can be a safe procedure from the very beginning in newly established bariatric centers. Specific bariatric training with active proctoring by an experienced surgeon in a bariatric centre can improve the laparoscopic gastric bypass outcome during the learning curve.

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Implementation of laparoscopic sacrocolpopexy: establishment of a learning curve and short-term outcomes

Archives of Gynecology and Obstetrics ◽

10.1007/s00404-012-2391-6 ◽

2012 ◽

Vol 286 (4) ◽

pp. 983-988 ◽

Cited By ~ 27

Author(s):

Susana Mustafa ◽

Amnon Amit ◽

Shlomo Filmar ◽

Michael Deutsch ◽

Itamar Netzer ◽

...

Keyword(s):

Learning Curve ◽

Laparoscopic Sacrocolpopexy ◽

Short Term

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Improving Outcomes Defending Patient Safety: The Learning Journey in Robotic Liver Resections

BioMed Research International ◽

10.1155/2019/1835085 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 7

Author(s):

Paolo Magistri ◽

Gian Piero Guerrini ◽

Roberto Ballarin ◽

Giacomo Assirati ◽

Giuseppe Tarantino ◽

...

Keyword(s):

Liver Resection ◽

Learning Curve ◽

Operative Time ◽

Short Term ◽

Robotic Liver Resection ◽

Referral Center ◽

Learning Journey ◽

Secondary Liver Neoplasms ◽

Time Of Operation ◽

Robotic Liver Surgery

Background. While laparoscopy is currently adopted for hepatic resections, robotic approaches to the liver have not gained wide acceptance. We decided to analyze the learning curve in the field of robotic liver surgery comparing short-term outcomes between the first and the second half of our series. Methods. We retrospectively reviewed demographics and clinical data of patients who underwent robotic liver resection at our institution from July 2014 through September 2017. 60 patients diagnosed with primary or secondary liver neoplasms or hydatid disease were included in this study. ASA PS >3, heart failure, respiratory insufficiency, and general contraindication to pneumoperitoneum were exclusion criteria. Results. 60 patients were included. We observed a statistically significant decrease in operative time (p<0.001), intraoperative blood loss (p=0.01), and postoperative complications (p<0.001) after 30 cases. From the interpretation of the CUSUM curve, the time of operation appears to be significantly reduced after the first 30 operations. Discussion. This is the first European analysis of the learning curve for robotic liver resection in an HPB and liver transplant referral center. However, more studies are needed to confirm such results outside a HPB referral center. This is crucial to develop formal credentialing protocols for both junior and senior surgeons.

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Laparoscopic Pyeloplasty - Our Early Experience

Journal of Paediatric Surgeons of Bangladesh ◽

10.3329/jpsb.v1i1.19448 ◽

2014 ◽

Vol 1 (1) ◽

pp. 10-14

Author(s):

Gazi Mohammad Zakir Hossain ◽

Mofizur Rahman ◽

Rashedul Hasan

Keyword(s):

Operative Time ◽

Perioperative Complications ◽

Laparoscopic Pyeloplasty ◽

Blunt Dissection ◽

Short Term ◽

Term Outcome ◽

Contralateral Kidney ◽

Age At Surgery ◽

Effective Option ◽

Successful Resolution

Objectives: To present our initial experience with laparoscopic pyeloplasty and to evaluate the safety and short-term outcome of this technique.Methods: Five patients underwent laparoscopic dismembered pyeloplasty for the management of ureteropelvic junction obstruction (UPJO) at Chittagong between July2007 to Mach2009. Patient age at surgery was 822 years. There were two boys and three girls. All had unilateral UPJO with a normal contralateral kidney. We used 5 mm instruments for grasping, blunt dissection, incising and suturing to facilitate safe and precise surgery. The outcome was measured by the operative time, perioperative complications and resolution of obstruction and symptoms.Results: Mean operative time was 195 minutes (range 175220 min). No major perioperative complications occurred in any cases. Overall, successful resolution of UPJO was observed in all the five cases evident by renogram.Conclusions: Laparoscopic pyeloplasty represents a safe and effective option in the surgical treatment of UPJO.DOI: http://dx.doi.org/10.3329/jpsb.v1i1.19448

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Introduction of gasless laparoscopic surgery as a minimally invasive procedure for endometrial cancer and its usefulness from the viewpoint of the learning curve

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02453-6 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Hiroe Ito ◽

Tetsuya Moritake ◽

Fumitoshi Terauchi ◽

Keiichi Isaka

Keyword(s):

Endometrial Cancer ◽

Laparoscopic Surgery ◽

Blood Loss ◽

Learning Curve ◽

Hospital Stay ◽

Open Surgery ◽

Operative Time ◽

Perioperative Complications ◽

Survival Rates ◽

Significant Difference

Abstract Background We investigated the usefulness of gasless laparoscopic surgery (GLS) using a subcutaneous abdominal wall lifting method for endometrial cancer. Methods We studied 105 patients with early endometrial cancer who underwent GLS (55) or open surgery (50). A uterine manipulator was used in all GLS cases. We compared operative time, blood loss, number of lymph nodes removed, hospital stay, perioperative complications, cases converted to laparotomy, and recurrence and survival rates. We also studied the learning curve and proficiency of GLS. Results The GLS group had significantly longer operative time (265 vs. 191 min), reduced blood loss (184 vs. 425 mL), shorter hospital stay (9.9 vs. 17.6 days), and fewer postoperative complications (1.8 vs. 12.0%) than the open group. No case was converted to laparotomy. Disease-free and overall survival rates at 4 years postoperatively (GLS vs. open groups) were 98.0 versus 97.8 and 100 versus 95.7%, respectively, and there was no significant difference between the groups. Regarding the learning curve for GLS, two different phases were observed in approximately 10 cases. Operator 2, who was not accustomed to laparoscopic surgery, showed a significant reduction in operative time in the later phase 2. Conclusions GLS for endometrial cancer results in less bleeding, shorter hospital stay, and fewer complications than open surgery. Recurrence and survival rates were not significantly different from those of open surgery. This technique may be introduced in a short time for operators who are skilled at open surgery but not used to laparoscopic surgery.

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Short-term surgical outcomes after Monopolar- versus Bipolar Transurethral Resection of the Prostate

QJM ◽

10.1093/qjmed/hcab110.003 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Ahmed Ramadan ◽

mohammed shoeb ◽

Mohamed Shabayek

Keyword(s):

Transurethral Resection ◽

Surgical Outcomes ◽

Operative Time ◽

Perioperative Complications ◽

Controlled Study ◽

Transurethral Resection Of Prostate ◽

Short Term ◽

Intraoperative Bleeding ◽

Significant Difference

Abstract Background Transurethral resection of prostate (TURP) is currently the gold standard for surgical treatment of benign prostatic hyperplasia (BPH), as this procedure results in the best improvement in symptoms and urine flow rate (1). Aim of the Work to compare between the two techniques used for transurethral resection of the prostate; Monopolar versus Bipolar resection as regards short term surgical outcomes, perioperative complications and early changes in quality of life.. Patients and Methods Randomized controlled study with simple randomization (1:1) of 80 patients with BPH candidate for transurethral resection of the prostate, 40 patients underwent M-TURP, and other 40 patients underwent B-TURP, their age mean age of paients included in our study 57-61 years old, mean prostate size 68-71 gm. Results Comparing intra-operative data in monopolar and bipolar TURP groups, our study reported that there was statistically significant decrease in volume of irrigation and operative time in B-TURP group in comparison to M-TURP group. although intra-operative complications; bleeding, electrolytes disturbance, fever and LUTS were lower in BTURP group; however, did not reach statistically significant. In M-TURP group ,there was statistically significance increase in change Hb, and time of post-oprative irrigation, IPSS in compared to B-TURP group. While in respect to PVR, time of catheterization and hospital stay, there was no statistically significant difference data among the two studied groups. Conclusion Bipolar TURP represents a promising endoscopic treatment for patients with BPH with decrease in volume of irrigation and reduced operative time, and less incidence of TUR syndrome, intraoperative bleeding, and postoperative complications .However, further investigations are needed with larger, preferably randomized multicentric controlled trials to confirm the results of this study in the future.

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Laparoscopic Pectopexy—CUSUM Learning Curve and Perioperative Complications Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10051052 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1052

Author(s):

Paulina Szymczak ◽

Magdalena Emilia Grzybowska ◽

Sambor Sawicki ◽

Dariusz Grzegorz Wydra

Keyword(s):

Learning Curve ◽

Hospital Stay ◽

Operative Time ◽

Perioperative Complications ◽

Kpss Test ◽

Estimated Blood Loss ◽

Cusum Analysis ◽

Grade Ii ◽

Complications Rate ◽

Prolonged Hospital

The study aimed to examine the learning curve and perioperative complications for laparoscopic pectopexy (LP). A total of 60 women with stage II–IV apical prolapse who underwent LP were dichotomized into groups: LSH(+) with concomitant laparoscopic supracervical hysterectomy (LSH), LSH(−) after previous supracervical/total hysterectomy. Operative time, estimated blood loss and hospitalization length were evaluated with cumulative sum (CUSUM) analysis and the Kwiatkowski–Phillips–Schmidt–Shin (KPSS) test, separately for two surgeons (A and B). Intraoperative and perioperative complications according to the Clavien–Dindo (C–D) classification were analyzed. Mean operative time, change in hemoglobin level, and postoperative hospital stay were 143.5 ± 23.1 min—1.5 ± 0.5g/dL and 2.5 ± 0.9 days, respectively. LSH during pectopexy was associated with longer operative time (p = 0.01) but not with higher intraoperative bleeding or prolonged hospital stay. Severe complications rate was low (1.7%) with one bowel injury in LSH(−) (C–D grade IIIb). No C–D grade II, IV and V complications were found. Conversion to open pectopexy, return to the operating room or blood transfusion were not required. The KPSS test showed that a steady operative time for Surgeon A was achieved after 28 procedures. A proficiency for laparoscopic pectopexy based on CUSUM analysis was observed after 38–40 procedures.

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Learning curve and global benchmark values of laparoscopic sleeve gastrectomy: results of first 100 cases of a newly trained surgeon in an Italian center of excellence

Updates in Surgery ◽

10.1007/s13304-021-01121-4 ◽

2021 ◽

Author(s):

Antonio Vitiello ◽

Giovanna Berardi ◽

Nunzio Velotti ◽

Vincenzo Schiavone ◽

Mario Musella

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Learning Curve ◽

Hospital Stay ◽

Operative Time ◽

Perioperative Outcomes ◽

Short Term ◽

Cusum Analysis ◽

Group 1

AbstractTo evaluate whether the learning curve for sleeve gastrectomy could be completed after 50 cases. First 100 patients undergoing LSG under a newly trained laparoscopic surgeon were included in this study and divided into two groups of 50 consecutive patients each. Perioperative outcomes were compared to recently introduced global benchmarks. Short-term weight loss was calculated as Total Weight Loss Percent (%TWL) and complications were classified in accordance with the Clavien–Dindo classification. CUSUM analysis was performed for operative time and hospital stay. Mean preoperative age and BMI were 41.8 ± 10.3 years and 42.9 ± 5.4 kg/m2, respectively. Demographics and rate of patients with previous surgery were comparable preoperatively in the two groups. Mean operative time was 92.1 ± 19.3 min and hospital stay was 3.4 ± 0.6 days as per our standard protocol of discharge. Uneventful postoperative course was recorded in 93% of patients and only one case of staple line leak was registered in the first 50 cases (group 1). No statistical difference in BMI and %TWL was found between the two groups at any time of follow-up. Comparison between two groups showed a significant reduction in hospital stay and operative time after the first 50 LSGs (p < 0.05). LSG can be performed by newly trained surgeons proctored by senior tutors. At least 50 cases are needed to meet global benchmark cut-offs and few more cases may be required to reach the plateau of the learning curve.

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