The Learning Curve for Totally Extraperitoneal (TEP) Repair in Inguinal Hernia.
- Author:
Jung Seob LEE
1
;
Il Dong KIM
;
Ki Ho KIM
;
Dong Woo SHIN
;
Byung Sun SUH
;
Sang Wook KIM
;
Hye In LIM
;
Jin Soo PARK
Author Information
1. Department of Surgery, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea. jspark@dmc.or.kr
- Publication Type:Original Article
- Keywords:
Laparoscopy;
TEP repair;
Inguinal hernia;
Learning curve
- MeSH:
Conversion to Open Surgery;
Hernia, Inguinal;
Herniorrhaphy;
Korea;
Laparoscopy;
Learning;
Learning Curve;
Length of Stay;
Operative Time;
Pyrazines;
Retrospective Studies
- From:Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2010;13(2):134-138
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Laparoscopic totally extraperitoneal (TEP) repair has been increasingly used for the treatment of inguinal hernias. This procedure is a very difficult technically and it requires a great deal of experience. However, there are only few studies on the learning curve (LC) of this procedure in the Korea literature. The aim of this study is to determine the number of case that are needed to overcome the learning curve of TEP hernia repairs and to document the surgical and clinical differences before and after overcoming the LC. METHODS: This study retrospectively reviewed 96 TEP hernia repairs that were performed by a single surgeon. The time required to overcome the LC was determined by examining the operation time. The preoperative and postoperative clinical data, such as incidental intraoperative findings, the rate of operative morbidity, the rate of conversion to an open procedure and the length of the postoperative hospital stay, were compared between the before and after groups with overcoming the LC. RESULTS: The 40th case was determined to be the transition point of overcoming the LC according to the operation time. The time before overcoming the LC averaged 73.0 minutes compared to 55.6 minutes after overcoming the LC. The postoperative hospital stay and the conversion rate were all significant (p<0.05). However, the other postoperative outcomes did not show significant differences. CONCLUSION: Based on the plateau of the operative time, this study shows that the downward slope of LC for TEP repair is at the 40th operation.
