• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • 2022 NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • SAGES 2021 Annual Meeting
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2021
      • SAGES 2020
      • SAGES 2019
      • SAGES 2018
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • SAGES Logo Products
    • “Unofficial” Logo Products
  • Log In

Mentored Trainees Obtain Comparable Operative Results to Experts in Complex Laparoscopic Colorectal Surgery

Introduction:
Laparoscopic Reversal of Hartman’s Procedure (LRHP) is a demanding laparoscopic colorectal procedure usually performed by experienced surgeons. The aim of this study is to evaluate the impact of an expert monitoring on the quality and results of LRHP performed by trainee surgeons.

Materials and methods:
Fourty-two LRHP were performed between 2000 and 2008. The procedure was standardized by an expert in colorectal surgery. This included port placement, adhesiolysis, rectal stump management, splenic flexure mobilization, and colorectal anastomosis with early introduction of the anvil through the stoma. Trainee surgeons (experience inferior to 20 colorectal surgeries) were mentored by an expert surgeon (experience over 2,000 colorectal procedures). Operative time, conversion, complications and post-operative outcome were measured. The group of patients operated upon by the senior colorectal surgeon was compared to the group of patients operated upon by the trainee surgeons while being mentored by the senior surgeon.

Results:
Each group included 21 patients. All patients underwent LRHP successfully and no mortality occurred. No intra-operative significant difference was observed between the group of trainees and experts: operative time was of 131 minutes (range: 70-230) vs. 132 minutes (range: 60-240); conversion rate: 2 (1 ureteral injury in the trainee’s group, repaired intra-operatively and 1 difficult adhesiolysis in the expert’s group). Complications occurred in 6 patients (14%), 3 requiring re-operation (7%). Two complications occurred in the trainee’s group (1 early anastomotic stricture requiring re-operation, 1 late stenosis requiring endoscopic dilation). Four complications occurred in the expert’s group (two patients were re-operated upon during the first 30 days, 1 for a post-operative obstruction and 1 for an early post-operative fistula) and two were treated medically (1 port site infection, 1 rectorrhagia). The patient post-operative outcomes were comparable in both groups: oral intake: 3 vs. 2 days; hospital stay: 6 vs. 7.5 days.

Conclusion:
Performing these difficult but standardized laparoscopic procedures offers the same results as when performed by trainees mentored by an expert surgeon, or carried out by an expert. The observed complication rate (14%) was comparable to that of experienced centres (131 to 48%2, including anastomotic leaks2; ureteral injury1, anastomotic strictures1,2 and re-operations (3.31 to 19%2). The expert mentoring does not prevent all intra-operative complications in challenging procedures, but can solve intra-operative technical problems that make the trainee more confident. Additionally, no intra-operative complication was encountered. Trainee mentoring and procedure standardization will probably increase their ability to perform more advanced procedures without any additional risk for the patient. Mentoring should be promoted as it can be performed locally or remotely through modern interactive technology.

References
1. Haughn C, Ju B, Uchal M, Arnaud JP, Reed JF, Bergamashi R. Complication rates after Hartmann’s reversal: open vs. laparoscopic approach. Dis Col Rect 2008;51:1232-1236.
2. Aydin HN, Remzi FH, Tekkis PP, Fazio VW. Hartmann’s reversal is associated with high postoperative adverse effects. Dis Col Rect 2005;48:2117-2126.


Session: Podium Presentation

Program Number: S037

58

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2010 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Surgery is Safer with Vaccination 1

Addressing Religious Concerns About COVID-19 Vaccine

This may be a difficult subject matter for you and your patient to talk about.  Be assured, all major organized religious groups encourage and recommend the COVID-19 vaccine. Listed below are references and websites you can direct your patient towards to help them make an informed decision with regards to their religious concerns against the […]

SAGES Statement on AAPI Violence

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) stands in solidarity with the Asian American and Pacific Islander (AAPI) community. In the summer of 2020, SAGES released a statement condemning the violence, racism, and hatred toward the Black community in the wake of George Floyd and Breonna Taylor’s murders. It is with great sorrow […]

Free SAGES Webinar: Lessons from COVID on Living and Thriving as Surgeons

SAGES recognizes that the COVID-19 pandemic has had a big impact on surgical practice and in surgeon wellness. SAGES’ Reimagining the Practice of Surgery Taskforce will present “Finding the Opportunities: Lessons from COVID and How We Live and Thrive as Surgeons”  to look at ways in which innovative leadership at various levels may help transform […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
[email protected]
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2022 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2022 Society of American Gastrointestinal and Endoscopic Surgeons