Training system for laparoscopy-assisted distal gastrectomy

Shinji Kuroda, Satoru Kikuchi, Naoto Hori, Shuichi Sakamoto, Tetsuya Kagawa, Megumi Watanabe, Tetsushi Kubota, Kazuya Kuwada, Michihiro Ishida, Hiroyuki Kishimoto, Futoshi Uno, Masahiko Nishizaki, Shunsuke Kagawa, Toshiyoshi Fujiwara

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: Laparoscopy-assisted distal gastrectomy (LADG) is likely to become a standard procedure for gastric cancer, which highlights the importance of establishing a training system in which even inexperienced surgeons can perform this procedure safely. This study assesses our training system for LADG based on short-term surgical outcomes. Methods: We evaluated retrospectively the short-term outcomes of 100 consecutive LADGs with curative D1/D1+ lymph node dissection. Our training system was assessed based on the learning curve of trainees, and factors related to achieving good-quality operations were analyzed statistically. Results: Overall, postoperative complications developed in 10 patients (10%), and included one case of anastomotic leakage (1%) and one case of pancreatic fistula (1%). The learning curve of the trainees plateaued after 10 operator cases in terms of operation time. The importance of the trainer’s position was also confirmed by the result that the operation time was significantly longer when trainees with ≤10 operator cases performed LADG with a trainer as scopist vs. a trainer as the first assistant. Univariate and multivariate analyses revealed that >10 operator cases were the most important factor for achieving good-quality operations. Conclusion: These results show that our current LADG procedure and training system are appropriate and effective.

Original languageEnglish
Pages (from-to)802-809
Number of pages8
JournalSurgery today
Volume47
Issue number7
DOIs
Publication statusPublished - Jul 1 2017

Keywords

  • Gastric cancer
  • Laparoscopy-assisted distal gastrectomy
  • Learning curve
  • Training system

ASJC Scopus subject areas

  • Surgery

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    Kuroda, S., Kikuchi, S., Hori, N., Sakamoto, S., Kagawa, T., Watanabe, M., Kubota, T., Kuwada, K., Ishida, M., Kishimoto, H., Uno, F., Nishizaki, M., Kagawa, S., & Fujiwara, T. (2017). Training system for laparoscopy-assisted distal gastrectomy. Surgery today, 47(7), 802-809. https://doi.org/10.1007/s00595-016-1439-9