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Learning curve for laparoscopic transabdominal preperitoneal repair: A single‐surgeon experience of consecutive 105 procedures
Author(s) -
Kuge Hiroyuki,
Yokoo Takashi,
Uchida Hideki,
Yamaoka Kentaro,
Yoshikawa Shusaku
Publication year - 2020
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12724
Subject(s) - medicine , learning curve , groin , surgery , fibrous joint , laparoscopy , general surgery , computer science , operating system
Based on previously published papers, the learning curve for laparoscopic groin hernia repair is controversial. The purpose of the present study was to evaluate the learning curve for laparoscopic surgery for groin hernia in a local hospital setting. Method We analyzed 100 consecutive cases of laparoscopic transabdominal preperitoneal repair performed by a single surgeon at a single facility from April 2013 to December 2015. The total operative time was divided into three parts: (a) preparing the peritoneal flap, (b) unfolding the mesh, and (c) suturing the peritoneum. A cumulative sum method for the total operative time and duration of the three parts was used to determine the learning curve. Results The learning curve was overcome after 75 cases based on cumulative sum analysis of the total operative time. The cumulative sum analysis of the times to unfold mesh and to suture the peritoneum indicated that the learning curve was overcome after 22 and 32 cases, respectively. The learning curve for preparing the peritoneal space was correlated with that for the entire procedure. No cases of recurrence were encountered. Conclusion At least 75 cases were needed to overcome the learning curve for laparoscopic transabdominal preperitoneal repair.