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Critical Appraisal of the Impact of Individual Surgeon Experience on the Outcomes of Minimally Invasive Distal Pancreatectomies: Collective Experience of Multiple Surgeons at a Single Institution.
- Source :
-
Surgical laparoscopy, endoscopy & percutaneous techniques [Surg Laparosc Endosc Percutan Tech] 2020 Aug; Vol. 30 (4), pp. 361-366. - Publication Year :
- 2020
-
Abstract
- Background: Presently, there are limited studies analyzing the learning experience of minimally invasive distal pancreatectomies (MIDPs) and these frequently focused on a single surgeon or institution learning curve. This study aims to critically analyze the impact of individual surgeon experience on the outcomes of MIDP based on the collective experiences of multiple surgeons at a single institution.<br />Methods: A retrospective review of 90 consecutive MIDP from 2006 to 2018 was performed. These cases were performed by 13 surgeons over various time periods. The cohort was stratified into 4 groups according to individual surgeon experience. The case experience of these surgeons was as follows: <5 cases (n=8), 6 to 10 cases (n=2), 11 to 15 cases (n=2), and 30 cases (n=1).<br />Results: The distribution of the 90 cases were as follows: experience <5 cases (n=44), 6 to 10 cases (n=20), 11 to 15 cases (n=11), and 15 cases (n=15). As individual surgeons gained increasing experience, this was significantly associated with increasingly difficult resections performed, increased frequency of the use of robotic assistance and decreasing open conversion rates (20.5% vs. 100% vs. 9.1% vs. 0%, P=0.038). There was no significant difference in other perioperative outcomes. These findings suggest that the outcomes of MIDP in terms of open conversion rate could be optimized after 15 cases. Subset analyses suggested that the learning curve for MIDP of low difficulty was only 5 cases.<br />Conclusion: MIDP can be safely adopted today and the individual surgeon learning curve for MIDP of all difficulties in terms of open conversion rate can be overcome after 15 cases.
- Subjects :
- Adult
Aged
Aged, 80 and over
Conversion to Open Surgery statistics & numerical data
Female
Humans
Laparoscopy adverse effects
Laparoscopy statistics & numerical data
Male
Middle Aged
Pancreatectomy adverse effects
Pancreatectomy statistics & numerical data
Pancreatic Neoplasms surgery
Retrospective Studies
Robotic Surgical Procedures adverse effects
Robotic Surgical Procedures statistics & numerical data
Young Adult
Clinical Competence
Laparoscopy education
Learning Curve
Pancreatectomy education
Postoperative Complications epidemiology
Robotic Surgical Procedures education
Subjects
Details
- Language :
- English
- ISSN :
- 1534-4908
- Volume :
- 30
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Surgical laparoscopy, endoscopy & percutaneous techniques
- Publication Type :
- Academic Journal
- Accession number :
- 32398450
- Full Text :
- https://doi.org/10.1097/SLE.0000000000000800