Ann Coloproctol.  2022 Dec;38(6):432-441. 10.3393/ac.2021.00689.0098.

The impact of assistants’ reverse alignment surgical skill proficiency on laparoscopic colorectal surgery

• Lee S

• KMID: 2537982
• DOI: http://doi.org/10.3393/ac.2021.00689.0098

Abstract

Purpose
We aimed to investigate the difference in the surgical outcome based on whether the assistant overcame the mirror image in laparoscopic colorectal surgery.
Methods
Three hundred patients who underwent laparoscopic colorectal surgery performed by single operator were divided into 2 groups. Based on the assistants’ experience, patients who underwent surgery involving 1 of 6 residents with an experience of fewer than 30 surgeries each were classified into group 1. Patients who underwent surgery involving a single fellow as an assistant with an experience of over 1,000 surgeries were classified into group 2. According to the type of surgery, patients were divided into left and right colon resection groups and the surgical outcome of groups 1 and 2 was investigated.
Results
Group 2 exhibited shorter operation time, less bleeding, shorter postoperative hospital stay, lower open conversion, and anastomotic leakage rate than group 1. In right colon resection, the operation time was shorter in group 2. In left colon resection, group 2 exhibited shorter operation time, less bleeding, shorter postoperative hospital stay, and lower anastomotic leakage rate. In the multivariate analysis, the assistant was a factor affecting the operation time in the entire surgery.
Conclusion
Assistants’ reverse alignment surgical skill proficiency was a factor affecting the operation time.

Keyword

Colorectal surgery; Laparoscopy; Learning curve