Evaluating the learning curve of no previous experienced laparoscopic surgeon in laparoscopy assisted distal gastrectomy (LADG)

Makoto Shirai, Yoshito Kiyasu, Shigehiko Yagi. Ehime Prefectural Medical Center Digestive surgery.

?Background and Purpose?Laparoscopic distal gastrectomy (LADG) is a new standard surgical treatment for early gastric cancer in Japan. Our Hospital is a core hospital of a local city, bearing emergency care, doctor dispatch in the remote areas other than the cancer care. Surgeons play a great part in these health care programs, the introduction of LADG has been barred greatly before. Last year LADG was formally introduced, we decided to standardize an operation. We compared the perioperative complications and early patients outcomes from our initial 50 cases of LADG.

?Methods?In 2012, 50 LADG with cholecystectomy were performed by two surgeons, one with previous experience of more than 100 LADG, another with no previous experience of LADG. Operative equipments and procedure are simplified and we made it easy repeatedly. As for energy device, only LCS was employed and used only for its suitable procedure. Operative time and complications were compared with between the first 25 cases and the last 25 cases.

?Results?The patient’s characteristic showed no significant differences between the two periods. Operative time (200.7 vs 173.7 min.) showed significantly declining curve. Postoperative complications such as leakage did not appeared in all cases.

?Conclusions?Our Standardization of LADG may have played an important role in getting a good learning curve for LADG.

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