TITLE

Reaching proficiency in laparoscopic splenectomy

AUTHOR(S)
Nursal, Tarik Zafer; Ezer, Ali; Belli, Sedat; Parlakgumus, Alper; Caliskan, Kenan; Noyan, Turgut; Rodriguez, Damian Casadesus
PUB. DATE
August 2009
SOURCE
World Journal of Gastroenterology;8/28/2009, Vol. 15 Issue 32, p4005
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
AIM: To investigate the proficiency level reached in laparoscopic splenectomy using the learning curve method. METHODS: All patients in need of splenectomy for benign causes in whom laparoscopic splenectomy was attempted by a single surgeon during a time period of 6 years were included in the study (n = 33). Besides demographics, operation-related variables and the response to surgery were recorded. The patients were allocated to groups of five, ranked according to the date of the operation. Operation duration, complications, postoperative length of stay, conversion to laparotomy and splenic weight were then compared between these groups. RESULTS: There was a significant difference regarding operation times between the groups (P = 0.001). An improvement was observed after the first 5 cases. The learning curve was flat up to the 25th case. Following the 25th case the operation times decreased still further . There was no difference between the groups regarding the other parameters. CONCLUSION: Unlike the widely accepted "L" shape, the learning curve for laparoscopic splenectomy is a horizontal lazy "S" with two distinct slopes. Privileges may be granted after the first 5 cases. However proficiency seems to require 25 cases.
ACCESSION #
44140671

 

Related Articles

  • Hematological long-term results of laparoscopic splenectomy for patients with idiopathic thrombocytopenic purpura: a case control study. Berends, F.J.; Schep, N.; Cuesta, M.A.; Bonjer, H.J.; Kappers-Klunne, M.C.; Huijgens, P.; Kazemier, G. // Surgical Endoscopy;May2004, Vol. 18 Issue 5, p766 

    Background: Laparoscopic splenectomy (LS) for idiopathic thrombocytopenic purpura (ITP) appears, when compared to open splenectomy (OS), associated with immediate important advantages. However, in a number of patients splenectomy does not lead to an adequate response, or after...

  • Laparoscopic Splenectomy with the da Vinci Robot. Bodner, Johannes; Lucciarini, Paolo; Fish, John; Kafka-Ritsch, Reinhold; Schmid, Thomas // Journal of Laparoendoscopic & Advanced Surgical Techniques;Feb2005, Vol. 15 Issue 1, p1 

    Background: We report our first series of minimally invasive splenectomies with a robotic surgical system. Methods: From August 2001 to October 2003, laparoscopic splenectomies with the da Vinci® operating robot were performed in 7 patients (five females and two males, ages 20 to 74 years)....

  • Pyoderma Gangrenosum and Hairy Cell Leukemia. Kaplan, Richard P.; Newman, Gerald; Saperia, David // Journal of Dermatologic Surgery & Oncology;Sep87, Vol. 13 Issue 9, p1029 

    Hairy cell leukemia (HCL) is an uncommon hematologic malignancy in which simultaneous cutaneous disturbances of various types have been reported.¹ We report a case of a 62-year-old man with HCL who developed pyoderma gangrenosum (PG) at the site of incision for splenectomy. PG has been...

  • Long-term outcome after laparoscopic splenectomy related to hematologic diagnosis. Balagué, C.; Targarona, E. M.; Cerd´n, G.; Novell, J.; Montero, O.; Bendahan, G.; Garcia, A.; Pey, A.; Vela, S.; Diaz, M.; Trias, M.; Balagué, C; Cerdán, G; García, A; Trías, M // Surgical Endoscopy;Aug2004, Vol. 18 Issue 8, p1283 

    Background: Laparoscopic splenectomy (LS) has been demonstrated as an effective and safe treatment for hematological disorders requiring spleen removal, especially in cases of normal-sized spleens. However, although results are promising, long-term outcome data are lacking. We...

  • Some Unusual Indications Of Splenectomy. Parray, Fazl Q.; Wani, Nazir A.; Wani, Khursheed A.; Wani, Mehmood A.; Wani, Rouf A. // Internet Journal of Surgery;2006, Vol. 7 Issue 2, p23 

    While dealing with various hematological disorders which were subjected to therapeutic splenectomy in our department of general surgery at a tertiary care centre Sher-i-Kashmir Institute of Medical Sciences over a period of more than 20 years, we came across a rare group of diseases in our set...

  • Outcomes of Open Splenectomy for Hematologic Malignancy with Splenomegaly: A Contemporary Perspective. PATA, GIACOMO; DAMIANI, ENRICO; TOGNALI, DANIELA; SOLAINI, LEONARDO; WATT, JENNIFER; RAGNI, FULVIO // American Surgeon;Apr2015, Vol. 81 Issue 4, p414 

    Splenectomy for hematologic malignancy (HM) is considered a high-risk procedure, especially in cases of splenomegaly. We analyzed the postoperative course of 82 patients undergoing open splenectomy for HM-related splenomegaly (splenic craniocaudal length 15 cm or greater) in a high-volume...

  • Outpatient laparoscopic splenectomy. Edwin, B.; Skattum, X.; Ræder, J.; Trondsen, E.; Buanes, T. // Surgical Endoscopy;Sep2004, Vol. 18 Issue 9, p1331 

    Background: We assessed the feasibility of outpatient laparoscopic splenectomy, as performed by an experi- enced laparoscopic term and combined with optimal anesthesia. Methods: Inclusion criteria in the study was limited to patients not hospitalized before the procedure who had hematological or...

  • Laparoscopic Versus Open Splenectomy for Massive Splenomegaly: A Comparative Study. Owera, Anas; Hamade, Ayman M.; Bani Hani, Omaya I.; Ammori, Basil J. // Journal of Laparoendoscopic & Advanced Surgical Techniques;Jun2006, Vol. 16 Issue 3, p241 

    Background: Despite the benefits of the laparoscopic approach to splenectomy, its application in patients with massive splenomegaly (splenic weight ≥ 1000 g) remains controversial. In this study we evaluated the safety and feasibility of laparoscopic splenectomy for massive splenomegaly...

  • Use of a laparoscopic hand-assist device for accessory splenectomy. Kaban, O. K.; Czerniach, D. R.; Perugini, R. A.; Novitsky, Y. W.; Kelly, J. J.; Litwin, D. E. M.; Kaban, G K // Surgical Endoscopy;Jun2004, Vol. 18 Issue 6, p1001 

    Background: The use of a laparoscopic hand-assist device may aid in the identification of accessory spleens (ASs) and provide similar benefits to a conventional laparoscopic procedure. A patient with previous splenectomy for immune thrombocytopenic pupusa (ITP) and recurrent...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics