Resident training in single-incision laparoscopic colectomy

Tokuoka,Masayoshi; Ide,Yoshihito; Hirose,Hajime; Takeda,Mitsunobu; Hashimoto,Yasuji; Matsuyama,Jin; Yokoyama,Shigekazu; Fukushima,Yukio; Sasaki,Yo

doi:10.3892/mco.2015.649

November-2015 Volume 3 Issue 6

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

November-2015 Volume 3 Issue 6

Full Size Image

Article Open Access

Resident training in single-incision laparoscopic colectomy

Authors:
- Masayoshi Tokuoka
- Yoshihito Ide
- Hajime Hirose
- Mitsunobu Takeda
- Yasuji Hashimoto
- Jin Matsuyama
- Shigekazu Yokoyama
- Yukio Fukushima
- Yo Sasaki
View Affiliations / Copyright

Affiliations: Department of Surgery, Yao Municipal Hospital, Yao, Osaka 581‑0069, Japan

Copyright: © Tokuoka et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 1221-1228
|
Published online on: September 21, 2015

https://doi.org/10.3892/mco.2015.649
Expand metrics +

Abstract

Single-incision laparoscopic colectomy (SLC) is touted as an improved approach to minimally invasive surgery, although no data currently exist regarding the acquisition of this technique. The aim of this study was to evaluate resident performance and outcomes in patients undergoing SLC performed by residents vs. staff colorectal surgeons. A retrospective case‑control study was conducted, including 220 patients who underwent elective surgical intervention with multiport laparoscopic colectomy (MLC, n=141) or SLC (n=79) for colon cancer over a 24‑month period at Yao Municipal Hospital (Yao, Japan). Data on patient demographics, operative data, oncological outcomes and short‑term outcomes were evaluated for statistical significance. To investigate issues regarding the surgical procedures, the entire operation was recorded on video for all patients and was divided into 6 procedures, with each procedure measured in seconds. Senior‑level residents were able to safely perform MLC under appropriate experienced supervision. For SLC, 1 case required conversion to an open procedure. No case required additional trocar placement. The mean operative times were similar for the staff and resident groups for total colon cancer (192.5 and 217.5 min, respectively; P=0.88), whereas the operative times of the staff group for right‑sided colon cancer were significantly longer, and the operative times of the resident group for left‑sided colon cancer were significantly longer. In addition, the overall perioperative outcomes, including blood loss, number of harvested lymph nodes, length of the surgical margin and complications, were similar between the two groups. When video recordings were evaluated by dividing the surgical process for the right colon into 4 procedures and that for the left colon into 6 procedures, the results demonstrated that the residents required more time to close the mesenteric margin for the left colon compared with the staff performing the same procedure (3,470.1±1,258.5 vs. 5,218.6±2,341.2 sec; P=0.01). Therefore, senior‑level residents were able to safely perform SLC under appropriate experienced supervision. For the left colon, the main challenge for the residents appeared to be the closure of the mesenteric margin. Our data support that it is possible to train senior residents to complete a SLC safely and with the same efficacy as staff surgeons.

View Figures

View References

1	Yasuda K, Sonoda K, Shiroshita H, Inomata M, Shiraishi N and Kitano S: Laparoscopically assisted distal gastrectomy for early gastric cancer in the elderly. Br J Surg. 91:1061–1065. 2004. View Article : Google Scholar : PubMed/NCBI
2	Choi SI, Lee KY, Park SJ and Lee SH: Single port laparoscopic right hemicolectomy with D3 dissection for advanced colon cancer. World J Gastroenterol. 16:275–278. 2010. View Article : Google Scholar : PubMed/NCBI
3	Ramos-Valadez DI, Patel CB, Ragupathi M, Bartley Pickron T and Haas EM: Single-incision laparoscopic right hemicolectomy: Safety and feasibility in a series of consecutive cases. Surg Endosc. 24:2613–2616. 2010. View Article : Google Scholar : PubMed/NCBI
4	Hamzaoglu I, Karahasanoglu T, Baca B, Karatas A, Aytac E and Kahya AS: Single-port laparoscopic sphincter-saving mesorectal excision for rectal cancer: Report of the first 4 human cases. Arch Surg. 146:75–81. 2011. View Article : Google Scholar : PubMed/NCBI
5	Merchant AM and Lin E: Single-incision laparoscopic right hemicolectomy for a colon mass. Dis Colon Rectum. 52:1021–1024. 2009. View Article : Google Scholar : PubMed/NCBI
6	Uematsu D, Akiyama G, Matsuura M and Hotta K: Single-access laparoscopic colectomy with a novel multiport device in sigmoid colectomy for colon cancer. Dis Colon Rectum. 53:496–501. 2010. View Article : Google Scholar : PubMed/NCBI
7	Miller S, Causey MW, Damle A, Maykel J and Steele S: Single-incision laparoscopic colectomy: Training the next generation. Surg Endosc. 27:1784–1790. 2013. View Article : Google Scholar : PubMed/NCBI
8	Hohenberger W, Weber K, Matzel K, Papadopoulos T and Merkel S: Standardized surgery for colonic cancer: Complete mesocolic excision and central ligation-technical notes and outcome. Colorectal Dis. 11:354–364; discussion. 364-365.2009. View Article : Google Scholar
9	West NP, Hohenberger W, Weber K, Perrakis A, Finan PJ and Quirke P: Complete mesocolic excision with central vascular ligation produces an oncologically superior specimen compared with standard surgery for carcinoma of the colon. J Clin Oncol. 28:272–278. 2010. View Article : Google Scholar : PubMed/NCBI
10	West NP, Kobayashi H, Takahashi K, et al: Understanding optimal colonic cancer surgery: Comparison of Japanese D3 resection and European complete mesocolic excision with central vascular ligation. J Clin Oncol. 30:1763–1769. 2012. View Article : Google Scholar : PubMed/NCBI
11	Chen WT, Chang SC, Chiang HC, et al: Single-incision laparoscopic vs. conventional laparoscopic right hemicolectomy: A comparison of short-term surgical results. Surg Endosc. 25:1887–1892. 2011. View Article : Google Scholar : PubMed/NCBI
12	Ramos-Valadez DI, Ragupathi M, et al: Single-incision vs. conventional laparoscopic sigmoid colectomy: A case-matched series. Surg Endosc. 26:96–102. 2012. View Article : Google Scholar : PubMed/NCBI
13	Champagne BJ, Lee EC, Leblanc F, Stein SL and Delaney CP: Single-incision vs. straight laparoscopic segmental colectomy: A case-controlled study. Dis Colon Rectum. 54:183–186. 2011. View Article : Google Scholar : PubMed/NCBI
14	Champagne BJ, Papaconstantinou HT, Parmar SS, et al: Single-incision vs. standard multiport laparoscopic colectomy: A multicenter, case-controlled comparison. Ann Surg. 255:66–69. 2012. View Article : Google Scholar : PubMed/NCBI
15	Poon JT, Cheung CW, Fan JK, Lo OS and Law WL: Single-incision vs. conventional laparoscopic colectomy for colonic neoplasm: A randomized, controlled trial. Surg Endosc. 26:2729–2734. 2012. View Article : Google Scholar : PubMed/NCBI
16	Chew MH, Wong MT, Lim BY, Ng KH and Eu KW: Evaluation of current devices in single-incision laparoscopic colorectal surgery: A preliminary experience in 32 consecutive cases. World J Surg. 35:873–880. 2011. View Article : Google Scholar : PubMed/NCBI
17	Makino T, Milsom JW and Lee SW: Feasibility and safety of single-incision laparoscopic colectomy: A systematic review. Ann Surg. 255:667–676. 2012. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Resident training in single-incision laparoscopic colectomy

This article is mentioned in:

Abstract

Figure 1

Figure 2

Related Articles