Abstract
BackgroundThe use of laparoscopic surgery has become widespread, and many surgeons are striving to acquire the necessary techniques for it. The Endoscopic Surgical Skill Qualification System (ESSQS), established by the Japan Society for Endoscopic Surgery, serves to maintain and improve the quality of laparoscopic surgery in Japan. In this study, we aimed to determine whether ESSQS certification is useful in maintaining and improving the quality of surgical techniques and in standardization of laparoscopic surgery in Japan.MethodsThis retrospective study used data from the Institute for Integrated Medical Sciences, Tokyo Women’s Medical University, Japan. From January 2016 to October 2017, 241 patients with colorectal cancer underwent laparoscopic surgery. Of them, 220 patients were selected and divided into two groups on the basis of surgery performed by an ESSQS-qualified surgeon (QS group) (n = 170) and a non-ESSQS-QS (NQS) (n = 50). We compared the short-term results in the two groups and examined those before and after propensity score matching (PSM).ResultsMean operation time was longer in the NQS group than in the QS group. Furthermore, mean blood loss was significantly less in the QS group. These were similar before and after PSM. The rate of conversion to open surgery was significantly higher in the NQS group before PSM. However, the rate of postoperative complications was not different between the two groups.ConclusionsA laparoscopic procedure performed by ESSQS-QS often leads to good short-term outcomes. Thus, the ESSQS system works and is potentially useful in maintaining and improving the quality of surgical techniques and in standardization of laparoscopic surgery in Japan.
Highlights
The use of laparoscopic surgery has become widespread, and many surgeons are striving to acquire the necessary techniques for it
Patients were divided into two groups on the basis of surgery performed by an Endoscopic Surgical Skill Qualification System (ESSQS)-qualified surgeon (QS group) (n = 170) and a nonESSQS-Qualified surgeon (QS) (NQS) (n = 50)
There was no difference between the QS and NQS groups regarding age (68.49 vs 66.30 years, P = 0.2273), gender (P = 0.4001), and body mass index (BMI) (22.21 vs 22.01 kg/m2, P = 0.694)
Summary
The use of laparoscopic surgery has become widespread, and many surgeons are striving to acquire the necessary techniques for it. Aoyama et al BMC Surgery (2019) 19:90 completion of all formal training, a certificate of membership of the JSES, and the special board of the Japan Society of Surgery, certificates of attendance of meetings and seminars held under the auspices of the JSES, a bibliography showing papers presented at the meetings or papers published in the authorized journals of the JSES, in addition to a list of endoscopic surgeries the applicant has performed by himself or herself over the last 3 years, together with an unedited Video, showing the surgery carried out by his or her own effort, and suturing and knotting techniques the applicant performed by him or herself They are all screened and evaluated very seriously by committee members elected from individual Committees in order to make a final decision. The main reason for the low success rate is attributable to their mainly immature techniques including careless handling of organs with inadequate instruments, or an inadequate operative field and a lack of communication among operators. [4]
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