TY - JOUR
T1 - The impact of the learning curve on adhesion formation in a laparoscopic mouse model
AU - Corona, Roberta
AU - Verguts, Jasper
AU - Binda, Maria Mercedes
AU - Molinas, Carlos Roger
AU - Schonman, Ron
AU - Koninckx, Philippe R.
N1 - Funding Information:
Supported by the Leuven Quality Surgery Fund (Fisher and Paykel Healthcare, Nordic Pharma, and eSaturnus NV).
PY - 2011/7
Y1 - 2011/7
N2 - Objective: To evaluate the impact of surgeon training on adhesion formation in a laparoscopic mouse model. Laparoscopic surgery and bowel manipulation was demonstrated to enhance postoperative adhesion formation. Design: Prospective randomized, controlled trial. Setting: University laboratory research center. Animal(s): 200 BALB/c and 200 Swiss female mice. Intervention(s): Adhesions were induced by opposing bipolar lesions and 60 minutes of pneumoperitoneum. Each surgeon operated on 80 mice (40 Swiss and 40 BALB/c), the only variable thus being his/her increasing experience. Some surgeons were already experienced gynecologists, others were starting their training. Main Outcome Measure(s): End points were the duration of surgery while performing the lesions. The adhesion formation was scored quantitatively (proportion and total) and qualitatively (extent, type, and tenacity) after 7 days. Result(s): With training, duration of surgery and adhesion formation decreased exponentially for all surgeons, whether experienced or not. Experienced surgeons had initially a shorter duration of surgery, less adhesion formation, and less de novo adhesions than inexperienced surgeons. Conclusion(s): These data suggest that laparoscopic skills improve with training, leading to a decrease in the duration of surgery and formation of adhesions. Therefore completion of a standardized learning curve should be mandatory when initiating adhesion formation studies both in laboratory or clinical setting.
AB - Objective: To evaluate the impact of surgeon training on adhesion formation in a laparoscopic mouse model. Laparoscopic surgery and bowel manipulation was demonstrated to enhance postoperative adhesion formation. Design: Prospective randomized, controlled trial. Setting: University laboratory research center. Animal(s): 200 BALB/c and 200 Swiss female mice. Intervention(s): Adhesions were induced by opposing bipolar lesions and 60 minutes of pneumoperitoneum. Each surgeon operated on 80 mice (40 Swiss and 40 BALB/c), the only variable thus being his/her increasing experience. Some surgeons were already experienced gynecologists, others were starting their training. Main Outcome Measure(s): End points were the duration of surgery while performing the lesions. The adhesion formation was scored quantitatively (proportion and total) and qualitatively (extent, type, and tenacity) after 7 days. Result(s): With training, duration of surgery and adhesion formation decreased exponentially for all surgeons, whether experienced or not. Experienced surgeons had initially a shorter duration of surgery, less adhesion formation, and less de novo adhesions than inexperienced surgeons. Conclusion(s): These data suggest that laparoscopic skills improve with training, leading to a decrease in the duration of surgery and formation of adhesions. Therefore completion of a standardized learning curve should be mandatory when initiating adhesion formation studies both in laboratory or clinical setting.
KW - Learning curve
KW - adhesions
KW - laparoscopy
KW - mouse model
KW - surgery
KW - training
UR - http://www.scopus.com/inward/record.url?scp=79959880732&partnerID=8YFLogxK
U2 - 10.1016/j.fertnstert.2011.04.057
DO - 10.1016/j.fertnstert.2011.04.057
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AN - SCOPUS:79959880732
SN - 0015-0282
VL - 96
SP - 193
EP - 197
JO - Fertility and Sterility
JF - Fertility and Sterility
IS - 1
ER -