Early Experience and Learning Curve of Solo Single-incision Distal Gastrectomy for Gastric Cancer: a Review of Consecutive 100 Cases

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2019 Jan 4

PMID 30604257

Citations 12

Authors

So Hyun Kang

Yo-Seok Cho

Sa-Hong Min

Young Suk Park

Sang-Hoon Ahn

Do Joong Park

Hyung-Ho Kim

Affiliations

Soon will be listed here.

Abstract

Background: Single-incision distal gastrectomy (SIDG) is technically difficult due to limited range of motion and unstable field of view. Solo surgery using a passive scope holder may be the key in allowing SIDG to be safer and efficient. We report our initial 100 cases of, to what we know, the world's first solo SIDG, and calculate the learning curve.

Methods: Prospectively collected database of 100 patients clinically diagnosed as gastric cancer who underwent solo SIDG from October 2013 until July 2016 was analyzed. All the operations were held by a single surgeon with no assistants. A passive laparoscopic scope holder was used to fix the field of view.

Results: The mean operation time was 120.6 ± 30.2 min, and the average estimated blood loss was 33.5 ± 55.7 ml. Average body mass index was 23.4 ± 2.9 kg/m. The median hospital stay was 5 (4-14) days, and the mean number of retrieved lymph nodes was 56.0 ± 22.8. There was no conversion to multiport or open surgery. Early complication of Clavien-Dindo grade III or more was 3%. Learning curve was calculated on operation time, and showed that an experienced surgeon in SIDG required 20 cases or less in stabilizing the operation time for solo SIDG.

Conclusions: Solo SIDG seems to be feasible and safe. The stable field of view created by a scope holder provides a favorable environment for a finer and more consistent operation. In addition, manpower can also be saved without affecting the quality of surgery.

Citing Articles

Learning Curve of Uniportal Compared With Biportal Endoscopic Techniques for the Treatment of Lumbar Disc Herniation.

Liu Y, Li X, Tan H, Hao X, Zhu B, Yang Y Orthop Surg. 2024; 17(2):513-524.

PMID: 39673164 PMC: 11787971. DOI: 10.1111/os.14312.

Safety and feasibility of single-incision laparoscopic distal gastrectomy in overweight and obese gastric cancer patients: a propensity score-matched analysis.

Lee E, Suh Y, Yoo M, Hwang D, Kang S, Lee S Gastric Cancer. 2024; 27(5):1136-1146.

PMID: 39023838 PMC: 11335889. DOI: 10.1007/s10120-024-01530-5.

Current Issues in Reduced-Port Gastrectomy: A Comprehensive Review.

Kim J J Gastric Cancer. 2024; 24(1):57-68.

PMID: 38225766 PMC: 10774760. DOI: 10.5230/jgc.2024.24.e9.

Establishing the Learning Curve of Laparoscopic and Robotic Distal Gastrectomy: a Systematic Review and Meta-Regression Analysis.

Chan K, Oo A J Gastrointest Surg. 2023; 27(12):2946-2982.

PMID: 37658172 DOI: 10.1007/s11605-023-05812-8.

Short- and long-term outcomes of single-port versus multiport laparoscopic radical gastrectomy for gastric cancer: a meta-analysis of propensity score-matched studies and randomized controlled trials.

Zhu G, Lang X, Zhou S, Li B, Sun Q, Yu L BMC Surg. 2023; 23(1):223.

PMID: 37559035 PMC: 10413728. DOI: 10.1186/s12893-023-02134-z.

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