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

2013 ◽  
Vol 11 (3) ◽  
pp. 235 ◽  
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

scholarly journals The Learning Curve of Computer-Assisted Free Flap Jaw Reconstruction Surgery Using 3D-Printed Patient-Specific Plates: A Cumulative Sum Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Wang-yong Zhu ◽  
Wing Shan Choi ◽  
May Chun Mei Wong ◽  
Jingya Jane Pu ◽  
Wei-fa Yang ◽  
...  
Keyword(s):  
Learning Curve ◽  
Hospital Stay ◽  
Bone Graft ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Cumulative Sum ◽  
Jaw Reconstruction ◽  
Cumulative Sum Analysis ◽  
Total Operation Time ◽  
3D Printed

BackgroundComputer-assisted jaw reconstruction (CAJR) has benefits in reducing operation time and improving reconstruction accuracy, compared to conventional freehand jaw reconstruction. However, no information is available regarding learning curves in CAJR with the use of 3D-printed patient-specific surgical plates (PSSP). The purpose of this study was to assess surgical outcomes and learning curve for the first 58 consecutive CAJR using 3D-printed PSSP performed by a single surgical team in a single institution.MethodsIn a prospective study, consecutive patients who underwent free flap CAJR using 3D-printed PSSP were included. The determination of proficiency, based on the cumulative sum of surgical success (no major adjustment of 3D-printed PSSP, flap survival) passing the acceptable boundary line of cumulative sum analysis, was the primary outcome. To find out any potential factors influencing the learning curve, baseline characteristics of patients were compared before and after proficiency achievement. Secondary outcomes included inflexion points of the total operation time, blood loss, length of hospital stay, and bone graft deviation, measured by the cumulative sum analysis.ResultsFrom December 2016 to November 2020, 58 consecutive cases underwent surgery performed by a single surgical team. The overall surgical success rate was 94.8% (55/58). A three-stage learning curve of primary outcome was observed. The proficiency was achieved after 23 cases. The proportions of advanced tumor staging and concomitant surgery after obtaining proficiency were significantly higher than those before achieving proficiency (p = 0.046 and p &lt; 0.001, respectively). Mean values of operation time, intraoperative blood loss, length of hospital stay, and bone graft deviation were 532.5 ± 119.2 min, 1,006.8 ± 547.2 ml, 16.1 ± 6.3 days, and 0.9 ± 1.2 mm, respectively. Two trends of learning curve were observed in the CUSUM analyses of total operation time, length of hospital stay, and bone graft deviation, in which the first and second inflexion points occurred between 8 and 17 cases and between 43 and 46 cases, respectively.ConclusionOur results revealed a three-stage learning curve of CAJR with the use of PSSP, including initial learning, plateau, and overlearning. Based on CUSUM analysis, the surgical proficiency was achieved after 23 cases, and total operation time, length of hospital stay, and bone graft deviation stabilized after 8–17 cases.

scholarly journals Hysterectomy and Adnexal Procedures by Vaginal Natural Orifice Transluminal Endoscopic Surgery (VNH): Initial Findings From a Korean Surgeon

2021 ◽  
Vol 7 ◽  
Author(s):  
Myeong-Seon Kim ◽  
Joseph J. Noh ◽  
Tae-Joong Kim
Keyword(s):  
Learning Curve ◽  
Pain Score ◽  
Endoscopic Surgery ◽  
Operation Time ◽  
Natural Orifice ◽  
Wound Retractor ◽  
Total Operation Time ◽  
Tertiary Center ◽  
Surgical Data ◽  
Installation Time

Objective: To evaluate feasibility and safety of hysterectomy and adnexal procedures by vaginal natural orifice transluminal endoscopic surgery (vNOTES).Study Design: This is a prospective observational study at a tertiary center and teaching University hospital. We enrolled prospectively 34 patients with benign diseases sequentially.Results: We measured baseline characteristics, surgical data, and pain score (VAS) after surgery. We surveyed before/after surgery. The time of port installation and each stage of surgery was measured. The learning curve was assessed through the graph according to the number of operations using linear and logarithmic regression curve estimation. The complications of surgery were investigated. The median age of the patients was 47.5 years (38–73). Median BMI was 22.4 (18.2–30.0). 20 cases of leiomyoma, four cases of adenomyosis, three cases of uterine prolapse, four cases of endometrial hyperplasia, and three cases of CIN were diagnosed. The median uterine weight was 180.0 g. The median port-installation time was 15.0 min (range, 4–35 min) and median total operation time was 85.5 min (range 43.0–132.0). Complications occurred in three patients. Two cases of bladder injury happened during vesicovaginal space dissection before the installation of the Wound Retractor (WR). One patient underwent transumbilical single-port surgery because of late-onset postoperative bleeding on the 13th postoperative day. The mean postoperative VAS scores were 3.36 immediately after surgery and 3.06, 2.79, and 2.45 at 6, 12, and 24 h after surgery, respectively. In continuous variable analysis, we detected a correlation between port-installation time and postoperative VAS ≥4 (pain score as need for medication). Based on a learning curve, port-installation time and total operation time appeared to reach the proficiency level by the 10th case.Conclusions: Although there were three complications, vNOTES offers advantages to patients and surgeons. More surgical techniques will be developed in vNOTES.

scholarly journals The meaning of laparoscopic procedure against inguinal hernia

2020 ◽  
Author(s):  
Hideaki Sato ◽  
Jyoji Yoshizawa ◽  
Akihide Sugiyama ◽  
Tomokazu Nakagami ◽  
Yu Watarai
Keyword(s):  
Inguinal Hernia ◽  
Laparoscopic Approach ◽  
Oral Intake ◽  
Operation Time ◽  
Surgical Time ◽  
Processus Vaginalis ◽  
Patent Processus Vaginalis ◽  
Postoperative Symptoms ◽  
Contralateral Patent Processus Vaginalis ◽  
Contralateral Hernia

Abstract Background Laparoscopic approach, especially laparoscopic percutaneous extraperitoneal closure (LPEC) for inguinal hernia (IH) is widely spread but few studies have compared its invasiveness with that of conventional approach (POTTS). This study compared the role and invasiveness of LPEC with POTTS at our institute. Material and methods The records of 940 IH patients from 2014 to 2019 were analyzed on the basis of age, sex, method of surgery, pre- and post-operative diagnosis, postoperative symptoms, and complications. Results The POTTS group comprised 393 males, of which 44 were diagnosed with contralateral hernia (7.1%). In the LPEC group, 158 males had an average age of 3.88 years. The contralateral patent processus vaginalis (CPPV) was identified in 148 patients during operation. POTTS operation time for patients aged < 1 year was 42.7 minutes, vs 33.4 minutes for LPEC. The two groups experienced comparable paces of fever and first oral intake time; however, pain and recurrence rate were greater in the LPEC group. Conclusion LPEC can be performed to avoid contralateral recurrences; surgical time is reduced for patients aged < 1 year. However, the reduced invasiveness of LPEC compared to that of POTTS did not minimize postoperative symptoms or complications.

scholarly journals The role of laparoscopic procedure against inguinal hernia comparing with open procedure

2021 ◽  
Author(s):  
Hideaki Sato ◽  
Jyoji Yoshizawa ◽  
Akihide Sugiyama ◽  
Tomokazu Nakagami ◽  
Yu Watarai
Keyword(s):  
Inguinal Hernia ◽  
Laparoscopic Approach ◽  
Oral Intake ◽  
Operation Time ◽  
Surgical Time ◽  
Open Operation ◽  
Postoperative Symptoms ◽  
Contralateral Patent Processus Vaginalis ◽  
Contralateral Hernia

Abstract BackgroundLaparoscopic approach, especially laparoscopic percutaneous extraperitoneal closure (LPEC) for inguinal hernia (IH) is widely spread but few studies have compared its invasiveness with that of conventional approach (OPEN). This study compared the role and postoperative early phase symptoms of LPEC with OPEN at our institute.MethodsThe records of 940 IH patients from 2014 to 2019 were analyzed on the basis of age, sex, method of surgery, pre- and post-operative diagnosis, postoperative symptoms, and complications.ResultsThe OPEN group comprised 393 males, of which 44 were diagnosed with contralateral hernia (7.1%). In the LPEC group, 158 males had an average age of 3.88 years. The contralateral patent processus vaginalis (CPPV) was identified in 148 patients during operation. OPEN operation time for patients aged <1 year was 42.7 minutes, vs 33.4 minutes for LPEC. The two groups experienced comparable paces of fever and first oral intake time; however, pain and recurrence rate were greater in the LPEC group.ConclusionLPEC can be performed to avoid contralateral occurrence; surgical time is reduced for patients aged <1 year. However, the reduced invasiveness of LPEC compared to that of OPEN did not minimize postoperative symptoms or complications.

The Learning Curve in Arthroscopic ACL Reconstruction. The impact on the Surgical Time and Postoperative Clinical Results

2018 ◽  
Vol 69 (10) ◽  
pp. 2874-2876
Author(s):  
Teodor Negru ◽  
Stefan Mogos ◽  
Ioan Cristian Stoica
Keyword(s):  
Anterior Cruciate Ligament ◽  
Learning Curve ◽  
Clinical Outcomes ◽  
Positive Impact ◽  
Cruciate Ligament ◽  
Clinical Results ◽  
Single Bundle ◽  
Surgical Time ◽  
Anterior Cruciate ◽  
The Impact

Rupture of the anterior cruciate ligament (ACL) is a common injury. The objective of the current study was to evaluate if the learning curve has an impact on surgical time and postoperative clinical outcomes after anatomic single-bundle anterior cruciate ligament reconstruction (ACLR) using an outside-in tunnel drilling hamstrings technique. The learning curve has a positive impact on surgical time but has no influence on postoperative clinical outcomes at short time follow-up.

scholarly journals Microscopic extra-laminar sequestrectomy (MELS) for the treatment of hidden zone lumbar disc herniation: report of the surgical technique, patient selection, and clinical outcomes

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chunxiao Wang ◽  
Yao Zhang ◽  
Xiaojie Tang ◽  
Haifei Cao ◽  
Qinyong Song ◽  
...  
Keyword(s):  
Blood Loss ◽  
Learning Curve ◽  
Clinical Outcomes ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Operation Time ◽  
Operation Duration ◽  
The Mean

Abstract Background The area which located at the medial pedicle, posterior vertebral body and ventral hemilamina is defined as the hidden zone. Surgical management of hidden zone lumbar disc herniation (HZLDH) is technically challenging due to its difficult surgical exposure. The conventional interlaminar approach harbors the potential risk of post-surgical instability, while other approaches consist of complicated procedures with a steep learning curve and prolonged operation time. Objective To introduce microscopic extra-laminar sequestrectomy (MELS) technique for treatment of hidden zone lumbar disc herniation and present clinical outcomes. Methods Between Jan 2016 to Jan 2018, twenty one patients (13 males) with HZLDH were enrolled in this study. All patients underwent MELS (19 patients underwent sequestrectomy only, 2 patients underwent an additional inferior discectomy). The nerve root and fragment were visually exposed using MELS. The operation duration, blood loss, intra- and postoperative complications, and recurrences were recorded. The Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and the modified MacNab criteria were used to evaluate clinical outcomes. Postoperative stability was evaluated both radiologically and clinically. Results The mean follow-up period was 20.95 ± 2.09 (18–24) months. The mean operation time was 32.43 ± 7.19 min and the mean blood loss was 25.52 ± 5.37 ml. All patients showed complete neurological symptom relief after surgery. The VAS and ODI score were significantly improved at the final follow-up compared to those before operation (7.88 ± 0.70 vs 0.10 ± 0.30, 59.24 ± 10.83 vs 11.29 ± 3.59, respectively, p < 0.05). Seventeen patients (81%) obtained an “excellent” outcome and the remaining four (19%) patients obtained a “good” outcome based the MacNab criteria. One patient suffered reherniation at the same level one year after the initial surgery and underwent a transforaminal endoscopic discectomy. No major complications and postoperative instability were observed. Conclusions Our observation suggest that MELS is safe and effective in the management of HZLDH. Due to its relative simplicity, it comprises a flat surgical learning curve and shorter operation duration, and overall results in reduced disturbance to lumbar stability.

scholarly journals A learning curve in using organ retractor for single-incision laparoscopic right colectomy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Toshio Shiraishi ◽  
Tetsuro Tominaga ◽  
Takashi Nonaka ◽  
Kiyoaki Hamada ◽  
Masato Araki ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Laparoscopic Surgery ◽  
Blood Loss ◽  
Learning Curve ◽  
Single Incision ◽  
Operation Time ◽  
Perioperative Outcomes ◽  
Single Incision Laparoscopic Surgery ◽  
Right Colon ◽  
Right Colon Cancer

AbstractSingle-incision laparoscopic surgery (SILS) has the potential to improve perioperative outcomes, including less postoperative pain, shorter operation time, less blood loss, and shorter hospital stay. However, SILS is technically difficult and needs a longer learning curve. Between April 2016 and September 2019, a total of 198 patients with clinical stage I/II right colon cancer underwent curative resection. In the case of the SILS approach, an organ retractor was usually used to overcome SILS-specific restrictions. The patients were divided into two groups by surgical approach: the SILS with organ retractor group (SILS-O, n = 33) and the conventional laparoscopic surgery group (LAC, n = 165). Clinical T status was significantly higher in the LAC group (p = 0.016). Operation time was shorter and blood loss was lower in the SILS-O group compared to the LAC group (117 vs. 197 min, p = 0.027; 10 vs. 25 mL, p = 0.024, respectively). In the SILS-O group, surgical outcomes including operation time, blood loss, number of retrieved lymph nodes, and postoperative complications were not significantly different between those performed by experts and by non-experts. Longer operation time (p = 0.041) was significantly associated with complications on univariate and multivariate analyses (odds ratio 2.514, 95%CI 1.047–6.035, p = 0.039). SILS-O was safe and feasible for right colon cancer. There is a potential to shorten the learning curve of SILS using an organ retractor.

scholarly journals Laparoscopic pectopexy: the learning curve and comparison with laparoscopic sacrocolpopexy

2021 ◽  
Author(s):  
Fei Chi Chuang ◽  
Yu Min Chou ◽  
Ling Ying Wu ◽  
Tsai Hwa Yang ◽  
Wen Hsin Chen ◽  
...  
Keyword(s):  
Learning Curve ◽  
Operation Time ◽  
Synthetic Mesh ◽  
Laparoscopic Sacrocolpopexy ◽  
Apical Prolapse ◽  
Steep Learning Curve ◽  
Surgical Method ◽  
Surgical Field ◽  
Uncontrolled Bleeding

Abstract Introduction and hypothesis In addition to laparoscopic sacrocolpopexy (LS), laparoscopic pectopexy (LP) is a novel surgical method for correcting apical prolapse. The descended cervix or vaginal vault is suspended with a synthetic mesh by fixing the bilateral mesh ends to the pectineal ligaments. This study was aimed at developing a learning curve for LP and to compare it with results with LS. Methods We started laparoscopic/robotic pectopexy in our department in August 2019. This retrospective study included the initial 18 consecutive women with apical prolapse receiving LP and another group undergoing LS (21 cases) performed by the same surgeon. The medical and video records were reviewed. Results The age was older in the LP group than in the LS group (65.2 vs 53.1 years). The operation time of LP group was significantly shorter than that of the LS group (182.9 ± 27.2 vs 256.2 ± 45.5 min, p < 0.001). The turning point of the LP learning curve was observed at the 12th case. No major complications such as bladder, ureteral, bowel injury or uncontrolled bleeding occurred in either group. Postoperative low back pain and defecation symptoms occurred exclusively in the LS group. During the follow-up period (mean 7.2 months in LP, 16.2 months in LS), none of the cases had recurrent apical prolapse. Conclusions Laparoscopic pectopexy is a feasible surgical method for apical prolapse, with a shorter operation time and less postoperative discomfort than LS. LP may overcome the steep learning curve of LS because the surgical field of LP is limited to the anterior pelvis and avoids encountering the critical organs.

scholarly journals LEARNING CURVE IN SINGLE-LEVEL MINIMALLY INVASIVE TLIF: EXPERIENCE OF A NEUROSURGEON

2017 ◽  
Vol 16 (4) ◽  
pp. 279-282 ◽  
Author(s):  
Samuel Romano-Feinholz ◽  
Sergio Soriano-Solís ◽  
Julio César Zúñiga-Rivera ◽  
Carlos Francisco Gutiérrez-Partida ◽  
Manuel Rodríguez-García ◽  
...  
Keyword(s):  
Blood Loss ◽  
Learning Curve ◽  
Hospital Stay ◽  
Learning Curves ◽  
Surgical Experience ◽  
Surgical Time ◽  
Intraoperative Bleeding ◽  
Single Level ◽  
Piecewise Regression ◽  
The Mean

ABSTRACT Objective: To describe the learning curve that shows the progress of a single neurosurgeon when performing single-level MI-TLIF. Methods: We included 99 consecutive patients who underwent single-level MI-TLIF by the same neurosurgeon (JASS). Patient’s demographic characteristics were analyzed. In addition, surgical time, intraoperative blood loss and hospital stay were evaluated. The learning curves were calculated with a piecewise regression model. Results: The mean age was 54.6 years. The learning curves showed an inverse relationship between the surgical experience and the variable analyzed, reaching an inflection point for surgical time in case 43 and for blood loss in case 48. The mean surgical time was 203.3 minutes (interquartile range [IQR] 150-240 minutes), intraoperative bleeding was 97.4ml (IQR 40-100ml) and hospital stay of four days (IQR 3-5 days). Conclusions: MI-TLIF is a very frequent surgical procedure due to its effectiveness and safety, which has shown similar results to open procedure. According to this study, the required learning curve is slightly higher than for open procedures, and is reached after about 45 cases.

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