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2003, Number 1

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Rev Med Inst Mex Seguro Soc 2003; 41 (1)

Surgical Experience in Laparoscopic Surgery

Ibarra JLE, Haro GL, Murguía AJA, Corbalá FC, Fletes KA, Velásquez LR

Language: Spanish
References: 23
Page: 75-80
PDF size: 67.82 Kb.


ABSTRACT

Objective: To determine the influence of experi-ence in laparoscopic conversions open to ab-dominal surgery in surgeons in the process of laparoscopy training. Material and methods: In three surgeons with ‹ 5 years of surgical skills and three with 5 years or more of surgical skills, at 45 days (Point A) and 90 days (Point B) from training initiation laparoscopic conversions were quantified; likewise, surgical time, length of stay, and CO2 consumption were measured and values between Point A and Point B were compared. Results: At Point A, 30 patients had been operated on and at Point B, 35 additional patients had been operated on. Surgical time, length of stay, and CO2 consumption between Points A and B were significantly reduced. As a whole, odds ratio (OR) for surgery conversions at point A was 2.95 (CI 95%: 0.90-9.90); however, if taking into account ‹ 5 years of surgical skills, OR for laparoscopic conversions at Point A was 3.33 (CI 95 %: 0.17-118), but at Point B, OR descended to 0.67 (CI 95 % 0.01-50.37). Conclusions: Fewer than 5 years of surgical skills in a surgeon’s abdominal laparoscopy surgery training is a factor that appears to promote open abdominal surgery conversion occurrence.


REFERENCES

  1. 1. Risucci D, Geiss A, Gellman L, Pinard B, Rosser J. Surgeon-specific factors in the acquisition of laparoscopic surgical skills. Am J Surg 2001;181 (4):289-293.

  2. 2. Allal H, Captier G, Lopez M, Forgues D, Galifer RB. Evaluation of 142 consecutive laparoscopic fundoplications in children: effects of the learning curve and technical choice. J Pediatr Surg 2001;36 (6):921-926.

  3. 3. Heniford BT, Backus CL, Matthews BD, Greene FL, Teel WB, Sing RF. Optimal teaching environ-ment for laparoscopic splenectomy. Am J Surg 2001;181(3):226-230.

  4. 4. Morgenstern L, Wong L, Berci G. Twelve-hundred open cholecystectomies before the laparoscopic era. A standard for comparison. Arch Surg 1992;127: 400-403.

  5. 5. Bailey RW, Flowers JL. Complications of lapa-roscopic surgery. St. Louis: Quality Medical Publishing; 1995.

  6. 6. Lewis J, Szabó Z. Formal laparoscopic skills training: Evaluation by surgical specialists in a health maintenance organization. En: Szabó Z, Lewis J, Fantini G. Surgical technology inter-national IV. San Francisco: Universal Medical Press, Inc.; 1995. p. 66-70.

  7. 7. Shapiro S, Partlow M, Daykhousky L, Gordon L. The use of models in laparoscopic education. En: Szabó Z, Lewis J, Fantini G. Surgical technology international IV. San Francisco: Universal Medical Press, Inc.; 1995. p. 61-65.

  8. 8. Soper NJ, et al. Diagnosis and management of biliary complications of laparoscopic cholecistec-tomy. Am J Surg 1993;165:663-669.

  9. 9. Meinero M, Melotti G, Mouret PH. Cirugía lapa-roscópica: una evolución de la filosofía quirúrgica. México: Médica Panamericana; 1996. p. 1-12.

  10. Zamora RV. Complicaciones de la colecistectomía laparoscópica. En: Cueto J, Weber A. Cirugía laparos-cópica. Primera edición. México: Interamericana-McGraw-Hill; 1994. p. 343.

  11. Zucker KA, Flowers JL, Bailey RW, Graham SM, Buell J, Imbembo AL. Laparoscopic management of acute cholecystitis. Am J Surg 1993;165:508-514.

  12. Ratter DW, Ferguson C, Warshaw AL. Factors associated with successful laparoscopic cholecystec-tomy for acute colelitiasis. Ann Surg 1993;217:233-236.

  13. Deziel DJ, Millikan KW, Economou SG, Doolas A, Ko ST, Airan MC. Complications of laparoscopic cholecystectomy: a national survey of 4292 hospitals and an analysis of 77 604 cases. Am J Surg 1993;165: 9-14.

  14. Williams LF Jr, Chapman WC, Bonau RA, McGee EC Jr RW, Jacobs JK. Comparison of laparoscopic cholecystectomy with open cholecystectomy in a single center. Am J Surg 1993;165:459-465.

  15. Rossi RL, Schirmer WJ, Braasch JW, Sanders LB, Munson JL. Laparoscopic bile duct injuries. Risk factors, recognition, and repair. Arch Surg 1992; 127:596-601.

  16. Davidoff AM, Pappas TN, Murray EA, Hilleren DJ, Johnson RD, Baker ME, et al. Mechanisms of major biliary injury during laparoscopic cholecystectomy. Ann Surg 1992;215:196-202.

  17. Hepp J, Ríos H, Sepúlveda R. Colecistectomía laparoscópica: casuística del Hospital Militar. Rev Chil Cirugia 1993;44:455-460.

  18. Cervantes J. Iatrogenia en cirugía. México: Salvat; 1991.

  19. Gadacz TR. Experience with laparoscopic chole-cystectomy. Am J Surg 1993;165:450-454.

  20. Collet D, Edye M, Perissat J. Convertions and complications of laparoscopic cholecystectomy. Results of a survey conducted by de French Society of Endoscopic Surgery and Interventional Radio-logy. Surg Endoscop 1993;7:334-338.

  21. Schwesinger WH, Diehl AK. Indicaciones cambiantes para la colecistectomía laparoscópica. Clin Quir Nort Am 1996;76:485-496.

  22. Cusick RA, Waldhausen JH. The learning curve associated with pediatric laparoscopic splenec-tomy. Am J Surg 2001;181(5):393-397.

  23. Kourambas J, Preminger GM. Advances in camera, video, and imaging technologies in laparoscopy. Urol Clin North Am 2001;28(1):5-14.




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