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Learning curve in human laparoscopic surgery

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Abstract

Laparoscopic urology has gained considerable popularity since the first laparoscopic nephrectomy was performed. However, the rapid application of the technique in urologic practice has led to increased reports of complications, even in the hands of surgeons who are well experienced in open surgical techniques, often early in a surgeon’s laparoscopic experience. The lack of translation of open surgical skills into laparoscopic results has led us to reappraise the learning curves relevant to open and laparoscopic surgery, to understand the differences, and enable us to make changes in the curriculum and the training to acquire laparoscopic skills.

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References and Recommended Reading

  1. Emken JL, McDougall EM, Clayman RV: Training and assessment of laparoscopic skills. JSLS 2004, 8:195–199. An overview of the present status of teaching laparoscopic skills, assessment of such skills, and incorporation of laparoscopic curricula into surgical training programs.

    PubMed  Google Scholar 

  2. Clayman RV, Kavoussi LR, Soper NJ, et al.: Laparoscopic nephrectomy: initial case report. J Urol 1991, 146:278–282.

    PubMed  CAS  Google Scholar 

  3. Fahlenkamp D, Rassweiler J, Fornara P, et al.: Complications of laparoscopic procedures in urology: experience with 2407 procedures at four German centers. J Urol 1999, 162:765–770.

    Article  PubMed  CAS  Google Scholar 

  4. Suzuki K, Ushiyama T, Kageyama S, et al.: Laparoscopic adrenalectomy-transperitoneal versus retroperitoneal approach [Abstract 590]. J Urol 1998, 159:155.

    Google Scholar 

  5. Simon SD, Castle EP, Ferrigni RG, et al.: Complications of laparoscopic nephrectomy: the Mayo clinic experience. J Urol 2004, 171:1447–1450.

    Article  PubMed  Google Scholar 

  6. Meraney AM, Samee AA, Gill IS: Vascular and bowel complications during retroperitoneal laparoscopic surgery. J Urol 2002, 168:1941–1944.

    Article  PubMed  Google Scholar 

  7. Gill IS, Kavoussi LR, Clayman RV, et al.: Complications of laparoscopic nephrectomy in 185 patients: a multi-institutional review. J Urol 1995, 154:479–483.

    Article  PubMed  CAS  Google Scholar 

  8. Parsons JK, Varkarakis I, Rha KH, et al.: Complications of abdominal urologic laparoscopy: longitudinal 5-year analysis. Urology 2004, 63:27–32.

    Article  PubMed  Google Scholar 

  9. Bhayani SB, Pavlovich CP, Strup SE, et al.: Laparoscopic radical prostatectomy: a multi-institutional study of conversion to open surgery. Urology 2004, 63:99–102.

    Article  PubMed  Google Scholar 

  10. Vallancien G, Cathelineau X, Baumert H, et al.: Complications of transperitoneal laparoscopic surgery in urology: review of 1311 procedures at a single center. J Urol 2002, 168:23–26.

    Article  PubMed  CAS  Google Scholar 

  11. Figert PL, Park AE, Witzke DB, et al.: Transfer of training in acquiring laparoscopic skills. J Am Coll Surg 2001, 193:533–537.

    Article  PubMed  CAS  Google Scholar 

  12. Rosenberg BH, Landsittel D, Averch TD: Can video games be used to predict or improve laparoscopic skills? J Endourol 2005, 19:372–376.

    Article  PubMed  Google Scholar 

  13. Cadeddu JA, Wolfe JS Jr, Nakada S, et al.: Complications of laparoscopic procedures after concentrated training in urological laparoscopy. J Urol 2001, 166:2109–2111.

    Article  PubMed  CAS  Google Scholar 

  14. Kneebone R: Simulation in surgical training: educational issues and practical implications. Med Educ 2003, 37:267–277.

    Article  PubMed  Google Scholar 

  15. Medina M: Formidable challenges to teaching advanced laparoscopic skills. JSLS 2001, 5:153–158.

    PubMed  CAS  Google Scholar 

  16. Nakada SY, Hedican SP, Bishoff JT, et al.: Expert videotape analysis and critiquing bene.t laparoscopic skills training of urologists. JSLS 2004, 8:183–186.

    PubMed  Google Scholar 

  17. Touijer K, Kuroiwa K, Saranchuk JW, et al.: Quality improvement in laparoscopic radical prostatectomy for pT2 prostate cancer: impact of video documentation review on positive surgical margin. J Urol 2005, 173:765–768.

    Article  PubMed  Google Scholar 

  18. Colegrove PM, Win.eld HN, Donovan JF Jr, et al.: Laparoscopic practice patterns among North American urologists 5 years after formal training. J Urol 1999, 161:881–886.

    Article  PubMed  CAS  Google Scholar 

  19. McDougall EM, S. L.: Surgical simulation. AUA Update Series Lesson 26 2005, 24:225–244. An excellent summary of the current status of surgical simulation, validity testing, and incorporation of simulators in surgical education.

    Google Scholar 

  20. Fried GM, Feldman LS, Vassiliou MC, et al.: Proving the value of simulation in laparoscopic surgery. Ann Surg 2004, 240:518–528.

    Article  PubMed  Google Scholar 

  21. Grantcharov TP, Kristiansen VB, Bendix J, et al.: Randomized clinical trial of virtual reality simulation for laparoscopic skills training. Br J Surg 2004, 91:146–150.

    Article  PubMed  CAS  Google Scholar 

  22. Fabrizio MD, Tuerk I, Schellhammer PF: Laparoscopic radical prostatectomy: decreasing the learning curve using a mentor initiated approach. J Urol 2003, 169:2063–2065. This study demonstrates a practical approach to introducing difficult laparoscopic procedures into a program.

    Article  PubMed  Google Scholar 

  23. Frede T, Erdogru T, Zukosky D, et al.: Comparison of training modalities for performing laparoscopic radical prostatectomy: experience with 1000 patients. J Urol 2005, 174:673–678. An important study exploring the transferability of laparoscopic skills between generations of surgeons.

    Article  PubMed  Google Scholar 

  24. Munver R, Del Pizzo JJ, Sosa RE: The advantages of handassisted laparoscopy. Curr Urol Rep 2004, 5:100–107.

    Article  PubMed  Google Scholar 

  25. Gaston KE, Moore DT, Pruthi RS: Hand-assisted laparoscopic nephrectomy: prospective evaluation of the learning curve. J Urol 2004, 171:63–67.

    Article  PubMed  Google Scholar 

  26. Nelson CP, Wolf JS Jr: Comparison of hand-assisted versus standard laparoscopic radical nephrectomy for suspected renal cell carcinoma. J Urol 2002, 167:1989–1994.

    Article  PubMed  Google Scholar 

  27. Poulakis V, Dillenburg W, Moeckel M, et al.: Laparoscopic radical prostatectomy: prospective evaluation of the learning curve. Eur Urol 2005, 47:167–175.

    Article  PubMed  Google Scholar 

  28. Ahlering TE, Skarecky D, Lee D, et al.: Successful transfer of open surgical skills to a laparoscopic environment using a robotic interface: initial experience with laparoscopic radical prostatectomy. J Urol 2003, 170:1738–1741. This study demonstrates that robotics can shorten the learning curve by transfer of open surgical skills to laparoscopy.

    Article  PubMed  Google Scholar 

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Correspondence to Inderbir S. Gill MD, MCh.

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Kumar, U., Gill, I.S. Learning curve in human laparoscopic surgery. Curr Urol Rep 7, 120–124 (2006). https://doi.org/10.1007/s11934-006-0070-5

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