Training in laparoscopic cholecystectomy - Quantifying the learning curve

J. G. Hunter, J. M. Sackier, G. Berci

Research output: Contribution to journalArticle

64 Scopus citations

Abstract

There is no clear consensus on the best way to train general surgeons to perform laparoscopic cholecystectomy (LC). We attempted to quantify the "learning curve" for 86 surgeons attending eight consecutive 3-day, three-pig courses in LC. Each step of the operation was scored by the instructor for successful performance: Uncomplicated pneumoperitoneum (p), cystic duct and artery dissection (cd), artery and duct clipping (cc), operative cholangiography (oc), gallbladder dissection without holes (gd), liver bed hemostasis (h), gallbladder removal in one piece (i), and no abdominal organ injury (in). As well, operative time, method of dissection, and contact Nd: YAG or electrocautery were recorded. The percentage of students successfully completing each task for the first and third pigs on which they acted as surgeon was as follows:[Figure not available: see fulltext.] The operative time for the first and third pigs was 1.3±0.56 and 0.70±0.34 (mean±SD) h, respectively (P<0.01). When students were trained with the contact Nd: YAG laser there was more blood loss than with electrosurgery (P<0.001). Statistically significant improvement could only be demonstrated in the most difficult task, gallbladder dissection without perforation, but that task had not been mastered by the end of 3 days. The flat portion of the laparoscopic cholecystectomy "training curve" had not been reached by the end of the program.

Original languageEnglish (US)
Pages (from-to)28-31
Number of pages4
JournalSurgical endoscopy
Volume8
Issue number1
DOIs
StatePublished - Jan 1 1994

Keywords

  • Laparoscopic cholecystectomy
  • Learning curve
  • Training

ASJC Scopus subject areas

  • Surgery

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