Learning and teaching advanced laparoscopic procedures: do alternating trainees impair a laparoscopic surgeon's...

Area of Science:

• Gynecologic Oncology
• Minimally Invasive Surgery
• Surgical Education

Background:

• Laparoscopic-assisted surgical staging (LASS) is an advanced procedure for endometrial cancer.
• The impact of teaching LASS on the attending surgeon's learning curve is not well-defined.

Purpose of the Study:

• To investigate whether teaching advanced laparoscopic procedures, specifically LASS for endometrial cancer, negatively affects the attending surgeon's learning curve.
• To compare outcomes and survival rates between different phases of the learning curve and teaching scenarios.

Main Methods:

• Retrospective study of 124 patients undergoing LASS for endometrial cancer.
• Cases were divided into initial learning phase (attending with faculty assistance) and post-learning phases (attending with attendings or residents as trainees).
• Comparison of general outcomes, oncologic parameters (pelvic lymph node yield), complications, and disease-free survival across groups.

Main Results:

• Pelvic lymph node yield met oncologic standards early and remained stable.
• A decrease in blood loss and length of stay was observed during the post-learning phase with attendings as trainees.
• Complications were concentrated in the early part of the series and not associated with trainee type.
• Disease-free survival was high and not significantly different among groups.

Conclusions:

• Attending surgeons can effectively teach LASS to trainees (attendings or residents) once proficiency is established.
• The inclusion of trainees does not impede the attending surgeon's learning curve progress.
• LASS can be safely taught without compromising patient outcomes or oncologic standards.