Nobuki Ichikawa1, Shigenori Homma1, Tadashi Yoshida1, Yosuke Ohno1, Hideki Kawamura1, Tomohiro Ishikawa2, Takashi Suzuki2, Takeshi Tsuji2, Masashi Ohira2, Yo Kamiizumi2, Akinobu Taketomi2. 1Department of Gastroenterological Surgery 1, Graduate School of Medicine, Hokkaido University,, 2Department of Surgery, Iwamizawa Municipal Hospital
INTRODUCTION: Laparoscopic colectomy has been widely spreading, and acquisition of its technique is concerned even for young surgeons. However, the safety of laparoscopic colectomy performed by beginner laparoscopic surgeon is questionable. We have been promoting to provide experiences of laparoscopic colectomy to young surgeons. In this study, we report the safety of laparoscopic colectomy performed by beginner surgeons.
METHODS AND PROCEDURES: Right colectomy and high anterior resection (because they are relatively easy procedures in laparoscopic colon cancer operations) were selected to the education surgery for beginner laparoscopic surgeon. A qualified laparoscopic surgeon in the Endoscopic Surgical Skill Qualification System (Japan Society for Endoscopic Surgery) always participated in operations as the teaching assistant. Twenty-three right colectomies and 19 high anterior resections were performed by beginner surgeons as the main surgeon between 2014 and 2016. Five trainees, who had 3-10 years prior experiences as surgeons, performed operations under teaching by qualified surgeon in this term.
RESULTS: Each trainee performed 13, 4, 3, 2 and 1 right colectomies and 7, 6, 4, 2 and 0 high anterior resections, respectively. In right colectomy, 11 males and 12 females were included. Mean age and body mass index were 79 and 23.2, respectively. Advanced cancer was diagnosed in 18 cases (78%) and mean tumor size was 50 mm. D2 or D3 lymph node dissection (according to the Japanese Society for Cancer of the Colon and Rectum guidelines) with functional end-to-end anastomosis were performed in all cases. The mean operation time and blood loss were 200 min and 73 mL, respectively. One patient was required conversion to open surgery due to the adhesion. Postoperative morbidities were occurred in two cases (small bowel obstruction and abdominal abscess). In high anterior resection, 9 males and 10 females were included. Mean age and body mass index were 72 and 22.1, respectively. Advanced cancer was diagnosed in 18 cases (68%) and mean tumor size was 33 mm. D2 or D3 lymph node dissection with anastomosis by double stapling technique were performed in all cases. The mean operation time and blood loss were 242 min and 27 mL, respectively. One patient was required conversion to open surgery due to the adhesion. No postoperative complication occurred.
CONCLUSION: Laparoscopic colectomy was safely performed by beginner laparoscopic surgeons as long as assisting by qualified surgeon.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 78781
Program Number: P297
Presentation Session: Poster (Non CME)
Presentation Type: Poster
