Laparoscopic Gastrectomy Performed by an Expert in Open Gastrectomy

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Laparoscopic gastrectomy (LG) is increasingly preferred by younger surgeons.
• Senior surgeons traditionally favor open gastrectomy (OG).
• Bridging the experience gap in LG is crucial for widespread adoption.

Purpose of the Study:

• To compare surgical outcomes of LG performed by a senior surgeon during their learning curve with those of a young surgeon's initial LG cases.
• To evaluate the feasibility and safety of LG adoption by experienced OG surgeons.

Main Methods:

• Retrospective comparison of 50 LG cases by a senior surgeon (LG-S group) versus 50 initial LG cases by a young surgeon (LG-Y group).
• Analysis of clinicopathological characteristics and surgical outcomes, including operation time, lymph node retrieval, hospital stay, and complication rates.
• Statistical comparison between the LG-S and LG-Y groups.

Main Results:

• The LG-S group underwent more frequent D2 lymphadenectomies compared to the LG-Y group.
• Operation time and lymph node yield were similar between the two surgeons.
• Postoperative hospital stay and complication rates were comparable for both groups.
• Both surgeons demonstrated improved operation times with increasing case numbers; lymph node yield improved significantly in the LG-Y group but not LG-S.

Conclusions:

• Laparoscopic gastrectomy outcomes achieved by a senior surgeon were comparable to those of a young surgeon, even with more extensive lymphadenectomies.
• Experienced open gastrectomy surgeons should not hesitate to pursue laparoscopic gastrectomy.
• This study supports the transition of experienced open surgeons to laparoscopic techniques.