[Learning curve and his consequences in laparoscopic antireflux surgery]

Area of Science:

• Gastroenterology
• Surgical Innovation
• Medical Education

Background:

• Laparoscopic antireflux surgery (LARS) is the standard for treating gastro-esophageal reflux (GER).
• Understanding the learning curve in LARS is crucial for optimizing patient outcomes.
• This study examines the evolution of surgical proficiency in laparoscopic fundoplication.

Purpose of the Study:

• To assess the learning curve's impact on laparoscopic fundoplication outcomes.
• To compare surgical times, complication rates, and recovery between early and later surgical periods.
• To evaluate the influence of surgeon experience on patient results in LARS.

Main Methods:

• A retrospective study of 40 GER patients undergoing laparoscopic fundoplication over six years.
• Patients were divided into two groups based on surgical order (first 20 vs. subsequent 20).
• Comparison of operating time, hospital stay, complication rates, and postoperative endoscopy findings.

Main Results:

• Significant reductions in average operating time were observed from group 1 to group 2 (129 min vs. 105 min).
• Operating times for giant hiatal hernias also decreased (143 min vs. 130 min).
• No statistically significant differences were found in complication rates or postoperative endoscopy results between the groups.

Conclusions:

• The learning curve for laparoscopic fundoplication demonstrates a significant decrease in operative time with experience.
• Despite the learning curve, surgeon experience did not adversely affect patient outcomes, complication rates, or recovery.
• Laparoscopic fundoplication can be safely implemented with consistent patient benefits, irrespective of the learning phase.