Learning curves for transperitoneal laparoscopic and extraperitoneal endoscopic paraaortic lymphadenectomy.
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.
Occelli
B
B
Hopital Jeanne de Flandre, CHRU, 2 Avenue Oscar Lambret 59037 Lille, Cedex, France.
Narducci
F
F
Lanvin
D
D
LeBlanc
E
E
Querleu
D
D
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