BACKGROUND: In spite of the emergence of laparoscopic cholecystectomy as the gold standard for treatment of symptomatic gallstones, questions still remain regarding its overall cost effectiveness, especially at low-volume centers where operating room (OR) time and operative complications are higher. We hypothesize that the presence of a well-organized, dedicated laparoscopic OR team will improve surgical outcomes for this procedure. This study compares the operative results of an advanced and a basic laparoscopic surgeon using either a designated laparoscopic operating team or a nondesignated team. METHODS: The hospital records for 71 elective laparoscopic cholecystectomies with cholangiograms were retrospectively reviewed and anesthesia times and conversion rates were analyzed. Procedures were performed either at a hospital with a dedicated laparoscopy team or a hospital with nondedicated OR personnel. All procedures were done by an advanced laparoscopic surgeon or a basic laparoscopic surgeon. RESULTS: Case characteristics were evenly matched between sites and surgeons. The mean total anesthesia time at the dedicated site was 120.8 min, compared to 152.3 min at the nondedicated site with a mean difference of 31.5 min (p = 0.001). A 12% conversion rate was documented at the nondedicated site. There were no conversions at the site with a dedicated laparoscopy team. No major complications were encountered in this series. CONCLUSION: This study demonstrates that having a designated laparoscopic trained team provides a time savings to both advanced and basic laparoscopic surgeons. Although no major complications were encountered, there was a significant conversion rate for the less experienced surgeon operating without the support of a trained team. The end result from having a dedicated team in endoscopic surgery is decreased operative time, an improvement in patient care, and decreased costs to the patient and institution.
BACKGROUND: In spite of the emergence of laparoscopic cholecystectomy as the gold standard for treatment of symptomatic gallstones, questions still remain regarding its overall cost effectiveness, especially at low-volume centers where operating room (OR) time and operative complications are higher. We hypothesize that the presence of a well-organized, dedicated laparoscopic OR team will improve surgical outcomes for this procedure. This study compares the operative results of an advanced and a basic laparoscopic surgeon using either a designated laparoscopic operating team or a nondesignated team. METHODS: The hospital records for 71 elective laparoscopic cholecystectomies with cholangiograms were retrospectively reviewed and anesthesia times and conversion rates were analyzed. Procedures were performed either at a hospital with a dedicated laparoscopy team or a hospital with nondedicated OR personnel. All procedures were done by an advanced laparoscopic surgeon or a basic laparoscopic surgeon. RESULTS: Case characteristics were evenly matched between sites and surgeons. The mean total anesthesia time at the dedicated site was 120.8 min, compared to 152.3 min at the nondedicated site with a mean difference of 31.5 min (p = 0.001). A 12% conversion rate was documented at the nondedicated site. There were no conversions at the site with a dedicated laparoscopy team. No major complications were encountered in this series. CONCLUSION: This study demonstrates that having a designated laparoscopic trained team provides a time savings to both advanced and basic laparoscopic surgeons. Although no major complications were encountered, there was a significant conversion rate for the less experienced surgeon operating without the support of a trained team. The end result from having a dedicated team in endoscopic surgery is decreased operative time, an improvement in patient care, and decreased costs to the patient and institution.
Authors: Daniel W Birch; H Jaap Bonjer; Claire Crossley; Gayle Burnett; Chris de Gara; Anthony Gomes; John Hagen; Angus G Maciver; C Dale Mercer; O Neely Panton; Chris M Schlachta; Andy J Smith; Garth L Warnock Journal: Can J Surg Date: 2009-08 Impact factor: 2.089
Authors: A Vallance; P Tcherveniakov; C Bogdan; N Chaudhuri; R Milton; E Kefaloyannis Journal: Ann R Coll Surg Engl Date: 2016-08-09 Impact factor: 1.891