Background and aim: Several studies have demonstrated that endoscopic thyroidectomy is a safe technique. Aim of the study is to evaluate the feasibility of video-assisted thyroidectomy (VAT) performed by a junior surgeon. Materials and methods: We consider 67 consecutive standard VAT gasless approaches. VAT was performed by an under 35-years-old surgeon trained in basic laparoscopy tutored by an experienced surgeon. Outcome measures were operative and hospitalization times, incision length, and complications. Conversion to open surgery was defined as the need to perform a longer incision. To establish the number of procedures required before achieving a safe VAT technique, procedures were divided into three chronological groups of about 30 lobectomies (Groups 1, 2, and 3). Results: Success rates of VAT were 90% in group 1, 97% group 2, 100% group 3 respectively (P<0.05). Most conversions were due to bleeding. In group 1, the overall mean operative time was 111 min, group 2, 93 min, group 3, 86 min (P<0.03). Mean length of incision significantly increased from the initial incision: group 1, +1.3 cm, group 2, +0.9, group 3, +0.5 cm (P>0.05). Group 3 had a faster recovery after surgery. The incidences of temporary hypoparathyroidism were 8.9%. The incidences of temporary RLN injury were 2.9%. Conclusions: To date there are no recommendations regarding the amount of endoscopic training required to safely perform VAT, but our experience demonstrated that surgeon's age cannot be considered having a negative effects on results. Success of VAT technique was considerably associated with experience: improved operative variables and safe technique were seen after 30 lobectomies.

Defining the learning curve for video-assisted thyroidectomy / G. Dionigi, L. Boni, F. Rovera, M. Annoni, F. Villa, R. Dionigi. - In: INTERNATIONAL JOURNAL OF SURGERY. - ISSN 1743-9191. - 6:suppl. 1(2008), pp. S1-S3. [10.1016/j.ijsu.2008.12.004]

Defining the learning curve for video-assisted thyroidectomy

G. Dionigi
Primo
;
L. Boni;
2008

Abstract

Background and aim: Several studies have demonstrated that endoscopic thyroidectomy is a safe technique. Aim of the study is to evaluate the feasibility of video-assisted thyroidectomy (VAT) performed by a junior surgeon. Materials and methods: We consider 67 consecutive standard VAT gasless approaches. VAT was performed by an under 35-years-old surgeon trained in basic laparoscopy tutored by an experienced surgeon. Outcome measures were operative and hospitalization times, incision length, and complications. Conversion to open surgery was defined as the need to perform a longer incision. To establish the number of procedures required before achieving a safe VAT technique, procedures were divided into three chronological groups of about 30 lobectomies (Groups 1, 2, and 3). Results: Success rates of VAT were 90% in group 1, 97% group 2, 100% group 3 respectively (P<0.05). Most conversions were due to bleeding. In group 1, the overall mean operative time was 111 min, group 2, 93 min, group 3, 86 min (P<0.03). Mean length of incision significantly increased from the initial incision: group 1, +1.3 cm, group 2, +0.9, group 3, +0.5 cm (P>0.05). Group 3 had a faster recovery after surgery. The incidences of temporary hypoparathyroidism were 8.9%. The incidences of temporary RLN injury were 2.9%. Conclusions: To date there are no recommendations regarding the amount of endoscopic training required to safely perform VAT, but our experience demonstrated that surgeon's age cannot be considered having a negative effects on results. Success of VAT technique was considerably associated with experience: improved operative variables and safe technique were seen after 30 lobectomies.
Learning curve; Video-assisted thyroidectomy
Settore MED/18 - Chirurgia Generale
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/883903
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