Skip to main content

Advertisement

SpringerLink
Log in

The learning curve for hand-assisted laparoscopic colectomy: a single surgeon’s experience

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Surgical experience and outcomes for hand-assisted laparoscopic colectomy were evaluated to define a learning curve.

Methods

This study included 60 patients who underwent hand-assisted laparoscopic colectomies performed by a single surgeon. They were analyzed as three consecutive equal groups: A, B, and C. Pearson’s chi-square test and one-way analysis of variance (ANOVA) were used to compare differences in demographics and perioperative parameters. Operative times were analyzed to document the learning curve for the procedure.

Results

There were no significant differences between the three groups in terms of age, sex, operative procedure, or comorbidity. Groups B and C showed significantly shorter operative times, significantly earlier recoveries of gastrointestinal function, less blood loss, and shorter hospital stays than group A. The incidence of operative complications was not significantly different among the three groups (35% vs 5% vs 15%; p = 0.07).

Conclusions

Approximately 21 to 25 cases were needed to achieve proficiency in this series.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.

Similar content being viewed by others

References

  1. Agachan F, Joo JS, Sher M, Weiss EG, Nogueras JJ, Wexner SD (1997) Laparoscopic colorectal surgery: do we get faster? Surg Endosc 11: 331–335

    Article  CAS  Google Scholar 

  2. Bennett CL, Stryker SJ, Ferreira MR, Adams J, Beart RW (1997) The learning curve for laparoscopic colorectal surgery: preliminary results from a prospective analysis of 1,194 laparoscopic-assisted colectomies. Arch Surg 132: 41–45

    Article  CAS  Google Scholar 

  3. Geis WP, Coletta AV, Verdeja JC, Plasencia G, Ojogho O, Jacobs M (1994) Sequential psychomotor skills development in laparoscopic colon surgery. Arch Surg 129: 206–212

    Article  CAS  Google Scholar 

  4. Gibson M, Byrd C, Pierce C, Wright F, Norwood W, Gibson T, Zibari GB (2000) Laparoscopic colon resections: a five-year retrospective review. Am Surg 66: 245–248

    CAS  PubMed  Google Scholar 

  5. Hsiao CW, Jao SW, C Lee C, Yeh CC, Lee TY, Kang JC (2004) Hand-assisted laparoscopic surgery with subtotal colectomy for colonic inertia: early experiences in Tri-Service General Hospital. J Soc Colon Rectal Surg 15: 69–74

    Article  Google Scholar 

  6. Kang JC, Chung MH, Chao PC, Yeh C, Hsiao CW, Lee TY, Jao SW (2004) Hand-assisted laparoscopic colectomy vs open colectomy: a prospective randomized study. Surg Endosc 18: 577–581

    Article  Google Scholar 

  7. Kurian MS, Patterson E, Andrei VE, Edye MB (2001) Hand-assisted laparoscopic surgery: an emerging technique. Surg Endosc 15: 1277–1281

    Article  CAS  Google Scholar 

  8. Lee TY, Ou JJ, Lai HJ, Hsiao CW, Lee CC, Chao PC, Jao SW, Kang JC (2005) Hand–assisted laparoscopic surgery for colorectal adenocarcinoma. J Soc Colon Rectal Surg 16: 23–27

    Google Scholar 

  9. Moore MJ, Bennett CL, Southern Surgeons’ Club (1995) Learning curve for laparoscopic cholecystectomy. Am J Surg 170: 55–59

    Article  CAS  Google Scholar 

  10. Nakajima PK, Lee SW, Cocilovo C, Foglia C, Sonoda T, Milsom JW (2004) Laparoscopic total colectomy: hand-assisted vs standard technique. Surg Endosc 18: 582–586

    Article  CAS  Google Scholar 

  11. Pietrabissa A, Moretto C, Carobbi A, Boggi U, Ghilli M, Mosca F (2002) Hand-assisted laparoscopic low anterior resection: initial experience with a new procedure. Surg Endosc 16: 431–435

    Article  CAS  Google Scholar 

  12. Ramos JM, Beart RW, Goes R, Ortega AE, Schlinkert RT (1995) Role of laparoscopy in colorectal surgery: a prospective evaluation of 200 cases. Dis Colon Rectum 38: 494–501

    Article  CAS  Google Scholar 

  13. Ramos JM, Gupta S, Anthone GJ, Ortega AE, Simons AJ, Beart RW Jr (1994) Laparoscopy and colon cancer: is the port site at risk? A preliminary report. Arch Surg 129: 897–899

    Article  CAS  Google Scholar 

  14. Rivadeneira DE, Marcello PW, Roberts PL, Rusin LC, Murray JJ, Coller JA, Schoetz DJ Jr (2004) Benefits of hand-assisted laparoscopic restorative proctocolectomy: a comparative study. Dis Colon Rectum 47: 1371–1376

    Article  Google Scholar 

  15. Schlachta CM, Mamazza J, Seshadri PA, Cadeddu M, Gregoire R, Poulin EC (2001) Defining a learning curve for laparoscopic colorectal resections. Dis Colon Rectum 44: 217–222

    Article  CAS  Google Scholar 

  16. See WA, Cooper CS, Fisher RJ (1993) Predictors of laparoscopic complications after formal training in laparoscopic surgery. JAMA 270: 2689–2692

    Article  CAS  Google Scholar 

  17. Senagore AJ, Luchtefeld MA, Mackeigan JM (1995) What is the learning curve for laparoscopic colectomy? Am Surg 8: 681–685

    Google Scholar 

  18. Senagore AJ, Luchtefeld MA, Mackeigan JM, Mazier WP (1993) Open colectomy versus laparoscopic colectomy: are there differences? Am Surg 59: 549–553, discussion 553–554

    CAS  PubMed  Google Scholar 

  19. Simons AJ, Anthone GJ, Ortega AE, Franklin M, Fleshman J, Geis WP, Beart RW Jr (1995) Laparoscopic-assisted colectomy learning curve. Dis Colon Rectum 38: 600–603

    Article  CAS  Google Scholar 

  20. Targarona EM, Gracia E, Garriga J, Martinez-Bru C, Cortes M, Boluda R, Lerma L, Trias M (2002) Prospective randomized trial comparing conventional laparoscopic colectomy with hand-assisted laparoscopic colectomy. Surg Endosc 16: 234–239

    Article  CAS  Google Scholar 

  21. Targarona EM, Martinez J, Nadal A, Balague C, Cardesa A, Pascual S, Trias M (1998) Cancer dissemination during laparoscopic surgery: tubes, gas, and cells. World J Surg 22: 55–60

    Article  CAS  Google Scholar 

  22. Wishner JD, Baker JW, Hoffman GC, Hubbard GW II, Gould RJ, Wohlgemuth SD, Ruffin WK, Melick CF (1995) Laparoscopic-assisted colectomy: the learning curve. Surg Endosc 9: 1179–1183

    Article  CAS  Google Scholar 

Download references

Acknowledgments

The authors express their thanks to Robert W. Beart Jr., M.D. for reviewing the manuscript.

Author information

Authors and Affiliations

  1. Division of Colorectal Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, ROC

    J.-C. Kang & Y.-J. Chang

  2. Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC

    S.-W. Jao & C.-C. Feng

  3. School of Nursing, Air Force General Hospital, Taipei, Taiwan, ROC

    M.-H. Chung

Authors
  1. J.-C. Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S.-W. Jao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M.-H. Chung
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C.-C. Feng
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Y.-J. Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J.-C. Kang.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kang, JC., Jao, SW., Chung, MH. et al. The learning curve for hand-assisted laparoscopic colectomy: a single surgeon’s experience. Surg Endosc 21, 234–237 (2007). https://doi.org/10.1007/s00464-005-0448-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-005-0448-3

Keywords

Search

Navigation