G Merola1, G Cavallaro2, O Iorio2, M Frascio3, E Pontecorvi1, F Corcione1, J Andreuccetti4, G Pignata5, C Stabilini3, U Bracale6. 1. Department of Gastroenterology, Endocrinology and Surgical Endoscopy, School of Medicine, University Hospital Federico II of Naples, Via Pansini 5, Naples, Italy. 2. Department of Surgery "P. Valdoni", School of Medicine, University Hospital "La Sapienza" of Rome, Rome, Italy. 3. Department of Surgical Sciences, School of Medicine, University of Genoa, Genoa, Italy. 4. Department of General and Mininvasive Surgery, "San Camillo" Hospital of Trento, Trento, Italy. 5. Department of General Surgery II, Civil Hospital of Brescia, Brescia, Italy. 6. Department of Gastroenterology, Endocrinology and Surgical Endoscopy, School of Medicine, University Hospital Federico II of Naples, Via Pansini 5, Naples, Italy. umbertobracale@gmail.com.
Abstract
PURPOSE: Inguinal hernia repair is one of the most performed procedure all over the world with more than 20 million procedures performed each year. Due to the lack of data in literature about the learning curve of the Lichtenstein procedure, we decided to reproduce a research on learning curves with the same methodology proposed in our previous study about laparoscopic hernia repair. The aim of this multicentre study was to analyse how many cases are required to achieve the learning curve for a Lichtenstein procedure. METHODS: We performed a retrospective analysis of the first 100 Lichtenstein procedures performed by 4 trainees from three different institutions and compared them with the same number of procedures performed by 3 senior surgeons from the same institutions. The data about the achieving of learning curve were evaluated with CUSUM and KPSS test. RESULTS: No differences about biometrical features were found between the seven groups of patients. CUSUM analysis showed that the trainees achieve the learning curve after 37-42 procedures, reaching an operative time similar to that one of the senior surgeons. CONCLUSIONS: In conclusion, we have shown that the number of procedures required to reach the learning curve from the beginning of surgical residency is around 40 hernia repairs. This number, produced in a controlled environment under strict supervision, could be the minimum requirement to start the procedure of accreditation and specialization in hernia surgery and is higher and steeper than previously reported.
PURPOSE: Inguinal hernia repair is one of the most performed procedure all over the world with more than 20 million procedures performed each year. Due to the lack of data in literature about the learning curve of the Lichtenstein procedure, we decided to reproduce a research on learning curves with the same methodology proposed in our previous study about laparoscopic hernia repair. The aim of this multicentre study was to analyse how many cases are required to achieve the learning curve for a Lichtenstein procedure. METHODS: We performed a retrospective analysis of the first 100 Lichtenstein procedures performed by 4 trainees from three different institutions and compared them with the same number of procedures performed by 3 senior surgeons from the same institutions. The data about the achieving of learning curve were evaluated with CUSUM and KPSS test. RESULTS: No differences about biometrical features were found between the seven groups of patients. CUSUM analysis showed that the trainees achieve the learning curve after 37-42 procedures, reaching an operative time similar to that one of the senior surgeons. CONCLUSIONS: In conclusion, we have shown that the number of procedures required to reach the learning curve from the beginning of surgical residency is around 40 hernia repairs. This number, produced in a controlled environment under strict supervision, could be the minimum requirement to start the procedure of accreditation and specialization in hernia surgery and is higher and steeper than previously reported.
Entities:
Keywords:
Inguinal hernia repair; Learning curve; Lichtenstein; Teaching in surgery; Training
Authors: Jacopo Andreuccetti; Alberto Sartori; Enrico Lauro; Lorenzo Crepaz; Silvia Sanna; Giusto Pignata; Umberto Bracale; Alberto Di Leo Journal: Updates Surg Date: 2021-04-30
Authors: Gianluca Cassese; Antonio Castaldi; Bader Al Taweel; Moglie Le Quintrec; Rodolphe Thuret; Francis Navarro; Fabrizio Panaro Journal: Int Urol Nephrol Date: 2022-02-03 Impact factor: 2.370
Authors: Bartlomiej Banas; Piotr Gwizdak; Paulina Zabielska; Piotr Kolodziejczyk; Piotr Richter Journal: Int J Environ Res Public Health Date: 2022-01-19 Impact factor: 3.390
Authors: Sri Vallabh Reddy Gudigopuram; Ciri C Raguthu; Harini Gajjela; Iljena Kela; Chandra L Kakarala; Mohammad Hassan; Rishab Belavadi; Ibrahim Sange Journal: Cureus Date: 2021-11-16