Learning curve of single port laparoscopic cholecystectomy determined using the non-linear ordinary least squares method based on a non-linear regression model: An analysis of 150 consecutive patients

Hyung Joon Han, Sae-Byeol Choi, Man Sik Park, Jin Suk Lee, Wan-Bae Kim, Taejin Song, Sang Yong Choi

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Introduction Single port laparoscopic surgery has come to the forefront of minimally invasive surgery. For those familiar with conventional techniques, however, this type of operation demands a different type of eye/hand coordination and involves unfamiliar working instruments. Herein, the authors describe the learning curve and the clinical outcomes of single port laparoscopic cholecystectomy for 150 consecutive patients with benign gallbladder disease. Method All patients underwent single port laparoscopic cholecystectomy using a homemade glove port by one of five operators with different levels of experiences of laparoscopic surgery. The learning curve for each operator was fitted using the non-linear ordinary least squares method based on a non-linear regression model. Results Mean operating time was 77.6 ± 28.5 min. Fourteen patients (6.0%) were converted to conventional laparoscopic cholecystectomy. Complications occurred in 15 patients (10.0%), as follows: bile duct injury (n = 2), surgical site infection (n = 8), seroma (n = 2), and wound pain (n = 3). One operator achieved a learning curve plateau at 61.4 min per procedure after 8.5 cases and his time improved by 95.3 min as compared with initial operation time. Younger surgeons showed significant decreases in mean operation time and achieved stable mean operation times. In particular, younger surgeons showed significant decreases in operation times after 20 cases. Conclusion Experienced laparoscopic surgeons can safely perform single port laparoscopic cholecystectomy using conventional or angled laparoscopic instruments. The present study shows that an operator can overcome the single port laparoscopic cholecystectomy learning curve in about eight cases.

Original languageEnglish
Pages (from-to)510-515
Number of pages6
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume18
Issue number4
DOIs
Publication statusPublished - 2011 Jul 1

Keywords

  • Laparoscopic cholecystectomy
  • Learning curve
  • Nonlinear ordinary least square model
  • Single port

ASJC Scopus subject areas

  • Surgery
  • Hepatology

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