A learning curve in using organ retractor for single-incision laparoscopic right colectomy

Abstract Single-incision laparoscopic surgery (SILS) has the potential to improve perioperative outcomes, including less postoperative pain, shorter operation time, less blood loss, and shorter hospital stay. However, SILS is technically difficult and needs a longer learning curve. Between April 201...

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Autores principales:	Toshio Shiraishi, Tetsuro Tominaga, Takashi Nonaka, Kiyoaki Hamada, Masato Araki, Yorihisa Sumida, Hiroaki Takeshita, Hidetoshi Fukuoka, Kazuo To, Kenji Tanaka, Terumitsu Sawai, Takeshi Nagayasu
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/bae04a0666274a9ca690a8cc28542af2
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spelling	oai:doaj.org-article:bae04a0666274a9ca690a8cc28542af22021-12-02T16:36:13ZA learning curve in using organ retractor for single-incision laparoscopic right colectomy10.1038/s41598-021-86168-42045-2322https://doaj.org/article/bae04a0666274a9ca690a8cc28542af22021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-86168-4https://doaj.org/toc/2045-2322Abstract Single-incision laparoscopic surgery (SILS) has the potential to improve perioperative outcomes, including less postoperative pain, shorter operation time, less blood loss, and shorter hospital stay. However, SILS is technically difficult and needs a longer learning curve. Between April 2016 and September 2019, a total of 198 patients with clinical stage I/II right colon cancer underwent curative resection. In the case of the SILS approach, an organ retractor was usually used to overcome SILS-specific restrictions. The patients were divided into two groups by surgical approach: the SILS with organ retractor group (SILS-O, n = 33) and the conventional laparoscopic surgery group (LAC, n = 165). Clinical T status was significantly higher in the LAC group (p = 0.016). Operation time was shorter and blood loss was lower in the SILS-O group compared to the LAC group (117 vs. 197 min, p = 0.027; 10 vs. 25 mL, p = 0.024, respectively). In the SILS-O group, surgical outcomes including operation time, blood loss, number of retrieved lymph nodes, and postoperative complications were not significantly different between those performed by experts and by non-experts. Longer operation time (p = 0.041) was significantly associated with complications on univariate and multivariate analyses (odds ratio 2.514, 95%CI 1.047–6.035, p = 0.039). SILS-O was safe and feasible for right colon cancer. There is a potential to shorten the learning curve of SILS using an organ retractor.Toshio ShiraishiTetsuro TominagaTakashi NonakaKiyoaki HamadaMasato ArakiYorihisa SumidaHiroaki TakeshitaHidetoshi FukuokaKazuo ToKenji TanakaTerumitsu SawaiTakeshi NagayasuNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Toshio Shiraishi Tetsuro Tominaga Takashi Nonaka Kiyoaki Hamada Masato Araki Yorihisa Sumida Hiroaki Takeshita Hidetoshi Fukuoka Kazuo To Kenji Tanaka Terumitsu Sawai Takeshi Nagayasu A learning curve in using organ retractor for single-incision laparoscopic right colectomy
description	Abstract Single-incision laparoscopic surgery (SILS) has the potential to improve perioperative outcomes, including less postoperative pain, shorter operation time, less blood loss, and shorter hospital stay. However, SILS is technically difficult and needs a longer learning curve. Between April 2016 and September 2019, a total of 198 patients with clinical stage I/II right colon cancer underwent curative resection. In the case of the SILS approach, an organ retractor was usually used to overcome SILS-specific restrictions. The patients were divided into two groups by surgical approach: the SILS with organ retractor group (SILS-O, n = 33) and the conventional laparoscopic surgery group (LAC, n = 165). Clinical T status was significantly higher in the LAC group (p = 0.016). Operation time was shorter and blood loss was lower in the SILS-O group compared to the LAC group (117 vs. 197 min, p = 0.027; 10 vs. 25 mL, p = 0.024, respectively). In the SILS-O group, surgical outcomes including operation time, blood loss, number of retrieved lymph nodes, and postoperative complications were not significantly different between those performed by experts and by non-experts. Longer operation time (p = 0.041) was significantly associated with complications on univariate and multivariate analyses (odds ratio 2.514, 95%CI 1.047–6.035, p = 0.039). SILS-O was safe and feasible for right colon cancer. There is a potential to shorten the learning curve of SILS using an organ retractor.
format	article
author	Toshio Shiraishi Tetsuro Tominaga Takashi Nonaka Kiyoaki Hamada Masato Araki Yorihisa Sumida Hiroaki Takeshita Hidetoshi Fukuoka Kazuo To Kenji Tanaka Terumitsu Sawai Takeshi Nagayasu
author_facet	Toshio Shiraishi Tetsuro Tominaga Takashi Nonaka Kiyoaki Hamada Masato Araki Yorihisa Sumida Hiroaki Takeshita Hidetoshi Fukuoka Kazuo To Kenji Tanaka Terumitsu Sawai Takeshi Nagayasu
author_sort	Toshio Shiraishi
title	A learning curve in using organ retractor for single-incision laparoscopic right colectomy
title_short	A learning curve in using organ retractor for single-incision laparoscopic right colectomy
title_full	A learning curve in using organ retractor for single-incision laparoscopic right colectomy
title_fullStr	A learning curve in using organ retractor for single-incision laparoscopic right colectomy
title_full_unstemmed	A learning curve in using organ retractor for single-incision laparoscopic right colectomy
title_sort	learning curve in using organ retractor for single-incision laparoscopic right colectomy
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/bae04a0666274a9ca690a8cc28542af2
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A learning curve in using organ retractor for single-incision laparoscopic right colectomy

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