Learning curve for hand-assisted laparoscopic D2 radical gastrectomy.

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Gastric cancer treatment often involves radical gastrectomy.
• Laparoscopic techniques offer potential benefits over open surgery.
• Hand-assisted laparoscopic surgery (HALG) combines direct visualization with laparoscopic advantages.

Purpose of the Study:

• To evaluate the learning curve associated with hand-assisted laparoscopic D2 radical gastrectomy (HALG).
• To identify key stages influencing proficiency in HALG for gastric cancer.
• To assess the impact of surgical experience on patient outcomes.

Main Methods:

• Retrospective analysis of clinical data from patients undergoing HALG for gastric cancer.
• Patients were divided into six groups (A-F) of 20 cases each, based on surgical date.
• Comparison of general patient information, intraoperative, and postoperative indicators across groups.

Main Results:

• The initial group (A) demonstrated significantly longer operative times for the hand-assisted stage compared to later groups.
• Postoperative intestinal function recovery time was also longer in group A.
• No significant differences were observed in total operative time, blood loss, lymph node yield, complications, or hospital stay among groups.

Conclusions:

• Hand-assisted laparoscopic D2 radical gastrectomy is a readily mastered surgical technique.
• The learning curve is primarily associated with the hand-assisted surgical stage.
• Surgical proficiency improves with experience, as indicated by reduced operative time in later stages.