The Beginner Laparoscopists Trends in the Learning Process of Laparoscopy for Adnexal Gynecological Pathologies—The Experience of Our Center
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Schollmeyer, T.; Soyinka, A.S.; Schollmeyer, M.; Meinhold-Heerlein, I. Georg Kelling (1866–1945): The root of modern day minimal invasive surgery. A forgotten legend? Arch. Gynecol. Obstet. 2007, 276, 505–509. [Google Scholar] [CrossRef]
- Hatzinger, M.; Badawi, J.K.; Häcker, A.; Langbein, S.; Honeck, P.; Alken, P. Georg Kelling (1866–1945): The man who introduced modern laparoscopy into medicine. Urologe A 2006, 45, 868–871. [Google Scholar] [CrossRef] [PubMed]
- Hatzinger, M.; Häcker, A.; Langbein, S.; Kwon, S.; Hoang-Böhm, J.; Alken, P. Hans-Christian Jacobaeus (1879–1937): The inventor of human laparoscopy and thoracoscopy. Urologe A 2006, 45, 1184–1186. [Google Scholar] [CrossRef]
- Morgenstern, L. The first laparoscopist in the United States: Bertram m. Bernheim, MD. Surg. Innov. 2007, 14, 241–242. [Google Scholar] [CrossRef] [PubMed]
- Alkatout, I.; Mechler, U.; Mettler, L.; Pape, J.; Maass, N.; Biebl, M.; Gitas, G.; Laganà, A.S.; Freytag, D. The Development of Laparoscopy—A Historical Overview. Front. Surg. 2021, 8, 655. [Google Scholar] [CrossRef]
- Nezhat, C.; Hajhosseini, B.; King, L.P. Laparoscopic management of bowel endometriosis: Predictors of severe disease and recurrence. JSLS J. Soc. Laparoendosc. Surg. 2011, 15, 431–438. [Google Scholar] [CrossRef] [Green Version]
- Kelley, W.E.J. The evolution of laparoscopy and the revolution in surgery in the decade of the 1990s. JSLS J. Soc. Laparoendosc. Surg. 2008, 12, 351–357. [Google Scholar]
- Kim, S.M.; Park, E.K.; Jeung, I.C.; Kim, C.J.; Lee, Y.S. Abdominal, multi-port and single-port total laparoscopic hysterectomy:eleven-year trends comparison of surgical outcomes complications of 936 cases. Arch. Gynecol. Obstet. 2015, 291, 1313–1319. [Google Scholar] [CrossRef] [PubMed]
- Donnez, O.; Jadoul, P.; Squifflet, J.; Donnez, J. A series of 3190 laparoscopic hysterectomies for benign disease from 1990 to 2006: Evaluation of complications compared with vaginal and abdominal procedures. BJOG Int. J. Obstet. Gynaecol. 2009, 116, 492–500. [Google Scholar] [CrossRef]
- Shore, E.M.; Grantcharov, T.P.; Husslein, H.; Shirreff, L.; Dedy, N.J.; McDermott, C.D.; Lefebvre, G.G. Validating a standardized laparoscopy curriculum for gynecology residents: A randomized controlled trial. Am. J. Obstet. Gynecol. 2016, 215, e1–e204. [Google Scholar] [CrossRef]
- Larsen, C.R.; Oestergaard, J.; Ottesen, B.S.; Soerensen, J.L. The efficacy of virtual reality simulation training in laparoscopy: A systematic review of randomized trials. Acta Obstet. Gynecol. Scand. 2012, 91, 1015–1028. [Google Scholar] [CrossRef]
- Hardon, S.F.; van Gastel, L.A.; Horeman, T.; Daams, F. Assessment of technical skills based on learning curve analyses in laparoscopic surgery training. Surgery 2021, 170, 831–840. [Google Scholar] [CrossRef]
- Hardon, S.F.; Horeman, T.; Bonjer, H.J.; Meijerink, W.J.H.J. Force-based learning curve tracking in fundamental laparoscopic skills training. Surg. Endosc. 2018, 32, 3609–3621. [Google Scholar] [CrossRef] [Green Version]
- Sonnadara, R.R.; Mui, C.; McQueen, S.; Mironova, P.; Nousiainen, M.; Safir, O.; Kraemer, W.; Ferguson, P.; Alman, B.; Reznick, R. Reflections on Competency-Based Education and Training for Surgical Residents. J. Surg. Educ. 2014, 71, 151–158. [Google Scholar] [CrossRef] [PubMed]
- Zhao, Z.; Gu, J. Open surgery in the era of minimally invasive surgery. Chin. J. Cancer Res. 2022, 34, 63–65. [Google Scholar] [CrossRef] [PubMed]
- Hudelist, G.; Korell, M.; Burkhardt, M.; Chvatal, R.; Darici, E.; Dimitrova, D.; Drahonovsky, J.; Haj Hamoud, B.; Hornung, D.; Krämer, B.; et al. Rates of severe complications in patients undergoing colorectal surgery for deep endometriosis—A retrospective multicenter observational study. Acta Obstet. Gynecol. Scand. 2022, 101, 1057–1064. [Google Scholar] [CrossRef]
- Jansen, F.W.; Kolkman, W. Implementation difficulties of advanced techniques in gynecological laparoscopy. Gynecol. Surg. 2008, 5, 261–264. [Google Scholar] [CrossRef] [Green Version]
- De Wilde, R.L. The Danger of Time-Consuming Operative Laparoscopies: Avoiding Severe Complications. Geburtshilfe Frauenheilkd. 2012, 72, 291–292. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Paek, J.; Kim, S.W.; Lee, S.H.; Lee, M.; Yim, G.W.; Nam, E.J.; Kim, Y.T. Learning curve and surgical outcome for single-port access total laparoscopic hysterectomy in 100 consecutive cases. Gynecol. Obstet. Investig. 2011, 72, 227–233. [Google Scholar] [CrossRef]
- Krentel, H.; De Wilde, R.L. Factors for a Successful Laparoscopic Hysterectomy in Very Large Uteri. Case Rep. Med. 2017, 2017, 1637472. [Google Scholar] [CrossRef] [Green Version]
- Campo, R.; Wattiez, A.; Tanos, V.; Di SpiezioSardo, A.; Grimbizis, G.; Wallwiener, D.; Brucker, S.; Puga, M.; Molinas, R.; O’Donovan, P.; et al. Gynaecological endoscopic surgical education and assessment. A diploma programme in gynaecological endoscopic surgery. Gynecol. Surg. 2016, 13, 133–137. [Google Scholar] [CrossRef] [Green Version]
- Eltabbakh, G.H.; Charboneau, A.M.; Eltabbakh, N.G. Laparoscopic surgery for large benign ovarian cysts. Gynecol. Oncol. 2008, 108, 72–76. [Google Scholar] [CrossRef] [PubMed]
- Bottomley, C.; Bourne, T. Diagnosis and management of ovarian cyst accidents. Best Pract. Res. Clin. Obstet. Gynaecol. 2009, 23, 711–724. [Google Scholar] [CrossRef]
- Morgenstern, L. Warning! Dangerous curve ahead: The learning curve. Surg. Innov. 2005, 12, 101–103. [Google Scholar] [CrossRef]
- Hopkins, M.P. The myths of laparoscopic surgery. Am. J. Obstet. Gynecol. 2000, 183, 1–5. [Google Scholar] [CrossRef]
- Wattiez, A.; Soriano, D.; Cohen, S.B.; Nervo, P.; Canis, M.; Botchorishvili, R.; Mage, G.; Poul, J.L.; Mille, P.; Bruhat, M.A. The learning curve of total laparoscopic hysterectomy: Comparative analysis of 1647 cases. J. Am. Assoc. Gynecol. Laparosc. 2002, 9, 339–345. [Google Scholar] [CrossRef]
- Kolkman, W.; Engels, L.E.; Smeets, M.J.; Jansen, F.W. Teach the teachers: An observational study on mentor traineeship in gynecological laparoscopic surgery. Gynecol. Obstet. Investig. 2007, 64, 1–7. [Google Scholar] [CrossRef]
- Bojahr, B.; Raatz, D.; Schonleber, G.; Abri, C.; Ohlinger, R. Perioperative complication rate in 1706 patients after a standardized laparoscopic supracervical hysterectomy technique. J. Minim. Invasive Gynecol. 2006, 13, 183–189. [Google Scholar] [CrossRef] [PubMed]
- Garrett, A.J.; Nascimento, M.C.; Nicklin, J.L.; Perrin, L.C.; Obermair, A. Total laparoscopic hysterectomy: The Brisbane learning curve. Aust. N. Z. J. Obstet. Gynaecol. 2007, 47, 65–69. [Google Scholar] [CrossRef] [PubMed]
- Twijnstra, A.R.; Blikkendaal, M.D.; Kolkman, W.; Smeets, M.J.; Rhemrev, J.P.; Jansen, F.W. Implementation of laparoscopic hysterectomy: Maintenance of skills after a mentorship program. Gynecol. Obstet. Investig. 2010, 70, 173–178. [Google Scholar] [CrossRef]
- Garry, R.; Fountain, J.; Mason, S.U.; Hawe, J.; Napp, V.; Abbott, J.; Clayton, R.; Phillips, G.; Whittaker, M.; Lilford, R.; et al. The eVALuate study: Two parallel randomised trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy. BMJ 2004, 328, 129. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Terzi, H.; Biler, A.; Demirtas, O.; Guler, O.T.; Peker, N.; Kale, A. Total laparoscopic hysterectomy: Analysis of the surgical learning curve in benign conditions. Int. J. Surg. 2016, 35, 51–57. [Google Scholar] [CrossRef]
- Tahmasbi Rad, M.; Wallwiener, M.; Rom, J.; Sohn, C.; Eichbaum, M. Learning curve for laparoscopic staging of early and locally advanced cervical and endometrial cancer. Arch. Gynecol. Obstet. 2013, 288, 635–642. [Google Scholar] [CrossRef] [Green Version]
- Schützendübel, M.; Boosz, A.; Baev, E.; Häberle, L.; Müller, A. Learning laparoscopic hysterectomy: Analysis of different surgeons’ individual learning curves. Arch. Gynecol. Obstet. 2022, 307, 1065–1072. [Google Scholar] [CrossRef]
- Bakay, K. Introduction of a Novel Modification in Laparoscopic Hysterectomy: The Bakay Technique. J. Minim. Invasive Gynecol. 2018, 25, 916–919. [Google Scholar] [CrossRef]
- Szymczak, P.; Grzybowska, M.E.; Sawicki, S.; Wydra, D.G. Laparoscopic Pectopexy-CUSUM Learning Curve and Perioperative Complications Analysis. J. Clin. Med. 2021, 10, 1052. [Google Scholar] [CrossRef]
- Togami, S.; Kawamura, T.; Fukuda, M.; Yanazume, S.; Kamio, M.; Kobayashi, H. Learning curve and surgical outcomes for laparoscopic surgery, including pelvic lymphadenectomy, for early stage endometrial cancer. Jpn. J. Clin. Oncol. 2019, 49, 521–524. [Google Scholar] [CrossRef]
- Charokar, K.; Modi, J.N. Simulation-based structured training for developing laparoscopy skills in general surgery and obstetrics & gynecology postgraduates. J. Educ. Health Promot. 2021, 10, 387. [Google Scholar]
- Appleton, S.; Huguelet, P. Laparoscopy Skills Simulation for the Obstetrics and Gynecology Resident. MedEdPORTAL 2016, 12, 10460. [Google Scholar] [CrossRef] [PubMed]
- Elessawy, M.; Mabrouk, M.; Heilmann, T.; Weigel, M.; Zidan, M.; Abu-Sheasha, G.; Farrokh, A.; Bauerschlag, D.; Maass, N.; Ibrahim, M.; et al. Evaluation of Laparoscopy Virtual Reality Training on the Improvement of Trainees’ Surgical Skills. Medicina 2021, 57, 130. [Google Scholar] [CrossRef] [PubMed]
- Willaert, W.; Van De Putte, D.; Van Renterghem, K.; Van Nieuwenhove, Y.; Ceelen, W.; Pattyn, P. Training models in laparoscopy: A systematic review comparing their effectiveness in learning surgical skills. Acta Chir. Belg. 2013, 113, 77–95. [Google Scholar] [CrossRef]
- Thinggaard, E. Take-Home Training in Laparoscopy. Dan. Med. J. 2017, 64, 1–17. [Google Scholar]
- Restaino, S.; Scutiero, G.; Taliento, C.; Poli, A.; Bernardi, G.; Arcieri, M.; Santi, E.; Fanfani, F.; Chiantera, V.; Driul, L.; et al. Three-dimensional vision versus two-dimensional vision on laparoscopic performance of trainee surgeons: A systematic review and meta-analysis. Updates Surg. 2023, 75, 455–470. [Google Scholar] [CrossRef]
- Degirmenci, Y.; Schepers, M.; Steetskamp, J.; Hasenburg, A.; Skala, C. Three-dimensional vs. two-dimensional endoscopic approach in urogynecology: A retrospective cohort study of laparoscopic sacrocolpopexy. J. Obstet. Gynaecol. Res. 2023, 49, 1028–1035. [Google Scholar] [CrossRef] [PubMed]
- Ma, J.; Yang, J.; Cheng, S.; Jin, Y.; Zhang, N.; Wang, C.; Wang, Y. The Learning Curve of Laparoendoscopic Single-Site Surgery in Benign Gynecological Diseases. J. Investig. Surg. 2022, 35, 363–370. [Google Scholar] [CrossRef] [PubMed]
- Rivas-López, R.; Sandoval-García-Travesí, F.A. Robotic surgery in gynecology: Review of literature. Cir. Y Cir. 2020, 88, 107–116. [Google Scholar] [CrossRef]
- Behbehani, S.; Suarez-Salvador, E.; Buras, M.; Magtibay, P.; Magrina, J. Mortality Rates in Benign Laparoscopic and Robotic Gynecologic Surgery: A Systematic Review and Meta-analysis. J. Minim. Invasive Gynecol. 2020, 27, 603–612. [Google Scholar] [CrossRef] [PubMed]
Variables | N | Duration (Mean ± Std Dev) (min) | p |
---|---|---|---|
Pathology | 0.161 | ||
Tubal | 56 | 109.14 ± 27.55 | |
Ovarian | 103 | 115.50 ± 26.99 | |
Laparoscopic approach | 0.786 | ||
Hasson | 64 | 113.98 ± 28.81 | |
Veress | 95 | 112.78 ± 26.34 | |
Number of trocars | 0.809 | ||
2 | 2 | 130.00 ± 14.14 | |
3 | 92 | 112.29 ± 28.02 | |
4 | 64 | 114.03 ± 26.77 | |
5 | 1 | 120.00 | |
Days of hospitalization | 0.405 | ||
3 | 26 | 119.62 ± 24.61 | |
4 | 96 | 110.88 ± 28.81 | |
5 | 35 | 114.14 ± 25.07 | |
6 | 2 | 130.00 | |
Operator | 0.227 | ||
A | 47 | 119.02 ± 25.13 | |
B | 59 | 110.68 ± 29.07 | |
C | 53 | 111.04 ± 26.77 |
Type of Surgery | Operator A | Operator B | Operator C |
---|---|---|---|
Laparoscopic ovarian cystectomy | |||
N (%) | 29 (61.7%) | 27 (45.8%) | 20 (37.7%) |
Duration (mean ± std) | 118.41 ± 23.96 | 114.00 ± 28.87 | 106.25 ± 22.23 |
Complications | 1 | - | 1 |
Laparoscopic adnexectomy | |||
N (%) | 4 (8.5%) | 6 (10.2%) | 10 (18.9%) |
Duration (mean ± std) | 120.00 ± 16.33 | 119.17 ± 39.04 | 129.00 ± 24.24 |
Complications | - | - | - |
Type of Surgery | N | Duration (Mean ± Std) (min) | p |
---|---|---|---|
Operator A | 0.01 | ||
Phase I | 17 | 127.65 ± 15.52 | |
Phase II | 12 | 105.33 ± 28.16 | |
Operator B | 0.01 | ||
Phase I | 13 | 127.69 ± 23.05 | |
Phase II | 14 | 101.29 ± 28.54 | |
Operator C | 0.48 | ||
Phase I | 5 | 100.00 ± 41.83 | |
Phase II | 15 | 108.33 ± 12.34 |
Type of Surgery | N | Duration (Mean ± Std) | p |
---|---|---|---|
Operator A | - | ||
Phase I | 0 | - | |
Phase II | 7 | 122.86 ± 29.84 | |
Operator B | 0.904 | ||
Phase I | 6 | 101.67 ± 21.13 | |
Phase II | 15 | 103.13 ± 26.16 | |
Operator C | 0.000 | ||
Phase I | 8 | 137.50 ± 21.87 | |
Phase II | 11 | 91.82 ± 23.48 |
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Sima, R.-M.; Crăițan, A.-V.; Pleș, L.; Bobircă, F.; Amza, M.; Gorecki, G.-P.; Georgescu, M.-T.; Hamoud, B.H. The Beginner Laparoscopists Trends in the Learning Process of Laparoscopy for Adnexal Gynecological Pathologies—The Experience of Our Center. Healthcare 2023, 11, 1752. https://doi.org/10.3390/healthcare11121752
Sima R-M, Crăițan A-V, Pleș L, Bobircă F, Amza M, Gorecki G-P, Georgescu M-T, Hamoud BH. The Beginner Laparoscopists Trends in the Learning Process of Laparoscopy for Adnexal Gynecological Pathologies—The Experience of Our Center. Healthcare. 2023; 11(12):1752. https://doi.org/10.3390/healthcare11121752
Chicago/Turabian StyleSima, Romina-Marina, Anca-Violeta Crăițan, Liana Pleș, Florin Bobircă, Mihaela Amza, Gabriel-Petre Gorecki, Mihai-Teodor Georgescu, and Bashar Haj Hamoud. 2023. "The Beginner Laparoscopists Trends in the Learning Process of Laparoscopy for Adnexal Gynecological Pathologies—The Experience of Our Center" Healthcare 11, no. 12: 1752. https://doi.org/10.3390/healthcare11121752
APA StyleSima, R.-M., Crăițan, A.-V., Pleș, L., Bobircă, F., Amza, M., Gorecki, G.-P., Georgescu, M.-T., & Hamoud, B. H. (2023). The Beginner Laparoscopists Trends in the Learning Process of Laparoscopy for Adnexal Gynecological Pathologies—The Experience of Our Center. Healthcare, 11(12), 1752. https://doi.org/10.3390/healthcare11121752