PURPOSE: Adequate training and close supervision by an experienced surgeon are crucial to assure the patient safety during laparoscopic training. This study evaluated the impact of tutorial assistance on the duration of surgery and postoperative complications after laparoscopic sigmoidectomy. METHODS: The data from 235 patients undergoing laparoscopic sigmoidectomy were collected. Operating surgeons were classified as either residents/registrars (group A, tutorial assistance) or consultants operating autonomously (group B). Groups were compared concerning the duration of surgery and in-hospital complications using a multivariable regression model accounting for the most relevant confounders. RESULTS: The median duration of the operation in group A (n = 75) was 221 min, and that in group B (n = 160) 189 min (p < 0.001). The risk of developing any in-hospital complication (Clavien-Dindo classification I-V) was 36.0 % in Group A and 32.5 % in group B (95 % CI -16.6, 9.6 %). The risk of developing moderate to severe surgical complications (Clavien-Dindo classification II-V) was 16.0 % in group A and 12.5 % in group B (95 % CI -13.3, 6.3 %). CONCLUSIONS: We were unable to demonstrate a clear impact of tutorial assistance on the risk of postoperative complications. Although associated with a longer duration of surgery, laparoscopic sigmoidectomy for acute recurrent sigmoid diverticulitis conducted by a junior supervised surgeon appears to be a safe surgical modality.
PURPOSE: Adequate training and close supervision by an experienced surgeon are crucial to assure the patient safety during laparoscopic training. This study evaluated the impact of tutorial assistance on the duration of surgery and postoperative complications after laparoscopic sigmoidectomy. METHODS: The data from 235 patients undergoing laparoscopic sigmoidectomy were collected. Operating surgeons were classified as either residents/registrars (group A, tutorial assistance) or consultants operating autonomously (group B). Groups were compared concerning the duration of surgery and in-hospital complications using a multivariable regression model accounting for the most relevant confounders. RESULTS: The median duration of the operation in group A (n = 75) was 221 min, and that in group B (n = 160) 189 min (p < 0.001). The risk of developing any in-hospital complication (Clavien-Dindo classification I-V) was 36.0 % in Group A and 32.5 % in group B (95 % CI -16.6, 9.6 %). The risk of developing moderate to severe surgical complications (Clavien-Dindo classification II-V) was 16.0 % in group A and 12.5 % in group B (95 % CI -13.3, 6.3 %). CONCLUSIONS: We were unable to demonstrate a clear impact of tutorial assistance on the risk of postoperative complications. Although associated with a longer duration of surgery, laparoscopic sigmoidectomy for acute recurrent sigmoid diverticulitis conducted by a junior supervised surgeon appears to be a safe surgical modality.
Authors: Paul Charron; Robert Campbell; Samuel Dejesus; Joseph Gallagher; Paul Williamson; Andrea Ferrara Journal: Dis Colon Rectum Date: 2007-11-28 Impact factor: 4.585
Authors: Timothy D Jackson; Jeffrey J Wannares; R Todd Lancaster; David W Rattner; Matthew M Hutter Journal: Surg Endosc Date: 2011-02-07 Impact factor: 4.584
Authors: Zvi H Perry; Uri Netz; Solly Mizrahi; Leonid Lantsberg; Boris Kirshtein Journal: J Laparoendosc Adv Surg Tech A Date: 2010-06 Impact factor: 1.878
Authors: Christine S Hwang; Christina R Pagano; Keith A Wichterman; Gary L Dunnington; Edward J Alfrey Journal: Surgery Date: 2008-08 Impact factor: 3.982