Abstract
Background. We report a single surgeon’s experience of 52 transperitoneal laparoscopic adrenalectomies (LAs) performed between 2001 and 2010. In addition, we compared this series with our first published series of LAs performed between 1994 and 2001. Methods. Our series includes 24 left, 20 right, and 4 bilateral LAs performed in 48 patients. To estimate the learning curve, we chronologically divided the sample of unilateral LAs into two groups of 22 patients and compared the operating time, estimated blood loss, maximum diameter of the lesion, complications, and length of hospital stay. Results. Mean operating time was significantly lower (94 versus 78 min, ) and mean intraoperative blood loss was significantly lower (156 versus 60 mL, ) after more experience had been gained. Additionally, a trend towards removing larger lesions was observed. There was no significant difference in terms of hospital stay. Conclusions. Observing a single surgeon’s experience of nine years in laparoscopic adrenalectomy, this study indicates that it takes approximately 20–25 procedures to flatten the learning curve. Thus, for single centers with a volume of approximately five LAs performed per year, we suggest a selection of a few experienced surgeons to perform LAs in order to improve outcomes.
Highlights
We report a single surgeon’s experience of 52 transperitoneal laparoscopic adrenalectomies (LAs) performed between 2001 and 2010
The aim of this paper is to present our subsequent series of 52 consecutive transperitoneal LAs performed between 2001 and 2010 in order to evaluate the learning curve associated with this technique
Our study indicates that for a single surgeon with advanced laparoscopic skills, approximately 25 procedures are necessary to gain the experience to flatten the learning curve as measured by operative time
Summary
We report a single surgeon’s experience of 52 transperitoneal laparoscopic adrenalectomies (LAs) performed between 2001 and 2010. To estimate the learning curve, we chronologically divided the sample of unilateral LAs into two groups of 22 patients and compared the operating time, estimated blood loss, maximum diameter of the lesion, complications, and length of hospital stay. Observing a single surgeon’s experience of nine years in laparoscopic adrenalectomy, this study indicates that it takes approximately 20–25 procedures to flatten the learning curve. There are no randomized controlled studies comparing open adrenalectomy versus LA, the multitude of retrospective analyses and case reports clearly demonstrate the benefits of LA in terms of feasibility, safety, morbidity, hospital stay, and recovery time [2,3,4,5,6,7]. We reevaluated the major parameters (indications, morbidity, hospital stay, blood loss, and lesion size) and especially focused on operative duration over time
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