• 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
      • Descriptions and Video Updates
      • 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
      • 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
    • COVID-19 Announcements
    • SAGES 2020 Meeting Information
    • 2021 Scientific Session Call For Abstracts
    • 2021 Emerging Technology Session Call For Abstracts
    • 2018 Prevent BDI Consensus Conference
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • Leadership Development and Health Policy Conference Videos
      • SAGES Quality Summit Meeting
      • SAGES 2019
      • SAGES 2018
      • SAGES 2017
      • SAGES 2016
      • SAGES 2015
      • SAGES 2014
      • SAGES 2013
    • Related Meetings Calendar
  • Membership
    • 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
    • COVID-19 Annoucements
    • 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
    • Troubleshooting Guides
  • Education
    • SAGES.TV Video Library
    • Virtual Hernia Clinic
    • The SAGES Safe Cholecystectomy Program
    • The 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
    • The SAGES HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Endorsed Courses
    • SAGES Robotics Fellows Courses
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Educational Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES Quality Initiative
    • 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 Research Opportunities
    • SAGES Endorsed Courses
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
    • Fellowship Certification
  • Search
    • COVID-19 Announcements
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Blog
    • All Blog Posts
    • COVID-19
    • Notes from the Battlefield
    • A (Positive) Way Forward
    • President Posts
  • Log In

Training Techniques in Laparoscopic Donor Nephrectomy

Adrian Billeter, MD, PhD, Elizabeth Lucich, Soloman Levy, MD, Eric Davis, MD, Michael Marvin, MD, Erica Sutton, MD

Hiram C. Polk, Jr. Department of Surgery, University of Louisville School of Medicine, Louisville, KY

Introduction: This study identifies and reviews published reports of training techniques for laparoscopic donor nephrectomy (LDN) in search of commonly utilized training methods as well as metrics of competency for the performance of LDN. The technique evolution in donor nephrectomy has been driven by the need to provide a safe yet less impactful operation for altruistic kidney donors. Minimal access surgery has accounted for the major reductions in patient morbidity in donor nephrectomy. In an era where quality improvement practices in surgery seek objective indicators for assessing procedural competency, the process by which surgeons train and demonstrate competency in laparoscopic donor nephrectomy (LDN) is poorly outlined for surgeons wishing to adopt this procedure and institutions required to credential surgeons in LDN.

Methods: Using PubMed, OVID, and Cochrane library databases, the terms “training”, “learning curve”, “animal model”, “education”, “single incision”, “single site”, and “robotic” were each combined in Boolean searches with “donor nephrectomy” to identify articles pertaining to training experiences in donor nephrectomy. All abstracts were reviewed for relevance by two reviewers. Abstracts were excluded if the study did not pertain to the introduction of a laparoscopic technique for donor nephrectomy. If not enough detail was given in the abstract, the manuscript was reviewed for training techniques employed by the surgeon and/or team introducing LDN. All relevant manuscripts were reviewed by 3 reviewers for the surgical technique being introduced, use of animal models, co-surgeons, surgeon specialty and prior training, institution type and volume, and how the training method was assessed. Frequency data was calculated where appropriate.

Results: Forty of 291 articles identified described training methods in LDN. Most described the evolution from open donor nephrectomy to LDN (85%). The majority of articles were from academic centers and centers performing less than 25 donor nephrectomies each year (85% and 46% respectively). The learner was an attending surgeon 90% of the time, most commonly a urologist with prior experience in laparoscopy or open nephrectomy. Simulation-based training methods were discussed in 4 articles, all of which described the use of porcine models. The proffered learning curve averaged 35 cases (range 10-95) measured as a decrease in operating time. Improved intraoperative, patient and recipient outcomes were observed for centers performing ≥50 LDN annually when compared to centers with an annual volume of <25. Co-surgeons were mentioned in 13 articles and were found to decrease blood loss and OR time, with no observed difference in patient outcomes.

Conclusions: Current Organ Procurement Network recommendations of 15 cases as surgeon or assistant for LDN fall well below the learning curve for high quality outcomes in LDN as described in the literature. Though simulation has demonstrated utility in ascending the learning curve for LDN, it is rarely discussed or evaluated as a training method. The assessment of training and competency for LDN is heterogeneous and objective learner-based metrics could help surgeons and institutions safely reach a quality standard for performing this high stakes operation.


Session: Poster Presentation

Program Number: P166

Post Views: 190

Share this:

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

Related

« Return to SAGES 2013 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

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 […]

Daniel Herron, MD

An opportunity to slow down and appreciate the small joys in life

Dan Herron, MD shares insights with Dana Telem, MD on lessons learned from COVID-19 Fear, anxiety and uncertainty has dominated the first half of 2020. Never before have we, as healthcare providers, been asked to do so much with so little—whether it’s resources like personal protective equipment, dusting off skills related to critical care, or […]

covid testing stock

Notes from the Battlefield – May 14, 2020

Coronavirus Global Surgical Collaborative (CVGSC)* An initiative sponsored by SAGES in collaboration with EAES, AEC, KSELS, and ELSA A group of surgical leaders from affected countries have joined to discuss what they are learning during this Covid-19 Global crisis. The following is a brief summary of what they feel may be useful information to disseminate to the surgical […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Newsletter Subscription

  • This field is for validation purposes and should be left unchanged.

Important Links

SAGES 2020 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

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

[footer_backtotop] · Log in

Copyright © 2021 Society of American Gastrointestinal and Endoscopic Surgeons · Legal
· Managed by BSC Management, Inc