The learning curve of laparoscopic inguinal hernia repair: A comparison of three inexperienced surgeons

Göksoy, Beslen; Azamat, İbrahim Fethi; Yılmaz, Gökhan; Sert, Özlem; Onur, Ender

The learning curve of laparoscopic inguinal hernia repair: A comparison of three inexperienced surgeons

dc.authorid	0000-0003-0889-9586
dc.contributor.author	Göksoy, Beslen
dc.contributor.author	Azamat, İbrahim Fethi
dc.contributor.author	Yılmaz, Gökhan
dc.contributor.author	Sert, Özlem
dc.contributor.author	Onur, Ender
dc.date.accessioned	2021-06-24T08:19:56Z
dc.date.available	2021-06-24T08:19:56Z
dc.date.issued	2021
dc.department	İstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Genel Cerrahi Ana Bilim Dalı
dc.description.abstract	Introduction: Studies with inexperienced surgeons in terms of the learning curve for laparoscopic totally extraperitoneal (TEP) inguinal hernia repair are limited. Aim: To compare three inexperienced surgeons in terms of the learning curve without supervision. Material and methods: Patients' data, which were from consecutive laparoscopic TEP hernioplasties between December 2017 and February 2020, were analysed retrospectively. The primary outcome was to compare the learning curve of three surgeons (Surgeon A, B, and C) in terms of complications, conversion, and duration of surgery. Secondary outcomes were recurrence rates. Results: A total of 299 patients were included in the study. Conversion and intraoperative complication rates decreased after the first 60 cases (from 10% to 2.5%, p = 0.013 and from 9% to 2.5%, p = 0.027, respectively). The mean operative time reached a plateau of less than 40 min after 51-81 cases (Surgeon A 51, B 71, and C 81 cases). Ageing was a risk factor for intraoperative complications and recurrence (p < 0.001, p = 0.008, respectively), and higher body mass index (BMI) was a risk factor for conversion (p = 0.004). Age = 60 years compared to age < 60 years increased intraoperative complications five-fold and recurrence six-fold (p = 0.001). On the other hand, BMI = 30 kg/m(2) increased the possibility of conversion to open surgery nine-fold (p < 0.001). In addition, a positive correlation was found between the operative time and the BMI and VAS score (p = 0.004, p = 0.015, respectively). Conclusions: In order to reach the plateau in the operative time during the TEP learning curve period, more than 50 cases should be experienced, whereas more than 60 cases are needed for conversion, intraoperative complications, and recurrence.
dc.identifier.citation	Göksoy, B., Azamat, İ. F., Yılmaz, G., Sert, Ö. ve Onur, E. (2021). The learning curve of laparoscopic inguinal hernia repair: A comparison of three inexperienced surgeons. Videosurgery and Other Miniinvasive Techniques, 16(2), 336-346. https://dx.doi.org/10.5114/wiitm.2020.100831
dc.identifier.doi	10.5114/wiitm.2020.100831
dc.identifier.endpage	346
dc.identifier.issn	1895-4588
dc.identifier.issn	2299-0054
dc.identifier.issue	2
dc.identifier.scopusquality	N/A
dc.identifier.startpage	336
dc.identifier.uri	https://dx.doi.org/10.5114/wiitm.2020.100831
dc.identifier.uri	https://hdl.handle.net/20.500.12511/7301
dc.identifier.volume	16
dc.identifier.wosquality	Q4
dc.indekslendigikaynak	Web of Science
dc.indekslendigikaynak	Scopus
dc.indekslendigikaynak	PubMed
dc.language.iso	en
dc.publisher	Termedia Publishing House Ltd
dc.relation.ispartof	Videosurgery and Other Miniinvasive Techniques	en_US
dc.relation.publicationcategory	Makale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rights	Attribution-NonCommercial-ShareAlike 4.0 International	*
dc.rights	info:eu-repo/semantics/openAccess
dc.rights.uri	https://creativecommons.org/licenses/by-nc-sa/4.0/	*
dc.subject	Laparoscopy
dc.subject	Totally Extraperitoneal
dc.subject	Inguinal Hernia
dc.subject	Learning Curve
dc.subject	Transabdominal Preperitoneal
dc.title	The learning curve of laparoscopic inguinal hernia repair: A comparison of three inexperienced surgeons
dc.type	Article