Related Experiment Videos
Transition from open to laparoscopic adrenalectomy: the need for advanced training
D L Maccabee1, A Jones, J Domreis
1Department of Surgery, Oregon Health and Sciences University, L223A, 3181 SW Sam Jackson Park Road, Portland, OR 97201-3098, USA. maccabee@ohsu.edu
Surgical Endoscopy
|July 23, 2003
Summary
Laparoscopic adrenalectomy (LA) shows no learning curve for operative time or complications, but reduced blood loss with experience. Most surgeons lack adequate training during residency for this procedure.
Area of Science:
- Surgical Innovation
- Minimally Invasive Surgery
- Endocrine Surgery
Background:
- Assessing the learning curve and current utilization of laparoscopic adrenalectomy (LA).
- Investigating shifts in adrenalectomy indications over the last decade.
Purpose of the Study:
- Determine the learning curve for laparoscopic adrenalectomy.
- Evaluate current practice patterns and indications for adrenalectomy.
Main Methods:
- Retrospective review of adrenalectomies performed since 1990.
- Mailed questionnaire to practicing community surgeons in Oregon.
Main Results:
- 75 LAs performed; average OR time 161 min, EBL 84 ml.
- No significant change in OR time or complications with experience, but decreased EBL (102 vs 47 ml).
- Limited resident training in LA; most practicing surgeons require postresidency training.
Conclusions:
- Operative time and complication rates do not improve with surgeon experience.
- Estimated blood loss (EBL) significantly decreases with experience.
- Laparoscopic adrenalectomy is more frequently used for benign conditions; open surgery for hormonal ablation and malignancy.