TITLE:
Evaluation of the Single-Port Laparoscopic Right Hemicolectomy Learning Curve
AUTHORS:
Virgilio V. George, Michael J. Guzman, Joshua A. Waters, Andrea L. Jester, Don J. Selzer, Bruce W. Robb
KEYWORDS:
Single-Port; Laparoscopy; Learning Curve; Colectomy
JOURNAL NAME:
Surgical Science,
Vol.4 No.10,
October
22,
2013
ABSTRACT:
Background: The use of single-port laparoscopy has gained popularity within recent years.
Part of the appeal in learning this approach is that it draws heavily from
concepts mastered through conventional laparoscopy. Various studies have shown
the efficacy and feasibility of the single-port laparoscopic approach, but
there are few that examine the learning curve in adopting this new technique. Objective: Our goal was to better
define the learning curve in performing a single-port laparoscopic right
hemicolectomy. Design: A review of
prospectively gathered operative data was performed to analyze the results of
single-port laparoscopic right hemicolectomies performed within our institution
by experienced laparoscopic surgeons. The first 100 cases were divided into
quintiles. Comparisons were made among the cohorts regarding patient
demographics, operative time, length of stay, conversions, and complications. Results: There was no difference among
quintiles with regard to age, sex, BMI, or ASA class. Operative time, conversions,
length of stay, and number of complications did not significantly vary among each
group of patients. There was a significant difference in estimated blood loss
and length of stay between the fifth cohort and the others due to one patient’s
poor outcome. Conclusions: The
single-port laparoscopic right hemicolectomy learning curve for surgeons already
skilled in laparoscopy is short. There are few differences in various outcome
measures among groups at any stage in the learning curve. The skills utilized
to perform conventional laparoscopic colorectal surgery readily translate to
the single-port approach and result in proficiency from nearly the start.