title: Learning curves for transperitoneal laparoscopic and extraperitoneal endoscopic paraaortic lymphadenectomy.
abstract: OBJECTIVE
  To compare learning curves for paraaortic lymphadenectomy by extraperitoneal endoscopic approach with those for transperitoneal laparoscopy.
  
  
  METHODS
  Randomized, long-term study (Canadian Task Force classification I).
  
  
  METHODS
  Animal laboratory.
  
  
  METHODS
  Sixty-six pigs.
  
  
  METHODS
  Laparoscopic and endoscopic paraaortic lymphadenectomy, 33 pigs in each group, performed by two surgeons competent in laparoscopic surgery but without experience in endoscopic paraaortic lymphadenectomy.
  
  
  RESULTS
  The duration of the procedure, number of lymph nodes removed, and number of residual nodes revealed learning curves that stabilized after the tenth procedure for each surgeon and for each approach. Vascular trauma depended on experience, occurring during the first 10 procedures for each surgeon. Efficacy and operative morbidity were comparable for the two procedures.
  
  
  CONCLUSIONS
  Endoscopic extraperitoneal lymphadenectomy has a steep learning curve similar to that for transperitoneal laparoscopy.
authors.affiliation: Hopital Jeanne de Flandre, CHRU, 2 Avenue Oscar Lambret 59037 Lille, Cedex, France.
authors.forename: B
authors.initials: B
authors.lastname: Occelli
authors.forename: F
authors.initials: F
authors.lastname: Narducci
authors.forename: D
authors.initials: D
authors.lastname: Lanvin
authors.forename: E
authors.initials: E
authors.lastname: LeBlanc
authors.forename: D
authors.initials: D
authors.lastname: Querleu
mesh_terms: D000818:Animals; D002983:Clinical Competence; D004724:Endoscopy; D005260:Female; D013509:Gynecologic Surgical Procedures; D010535:Laparoscopy; D008197:Lymph Node Excision / Q000379:methods*; D011897:Random Allocation; D013552:Swine; D013997:Time Factors