[Effect of the learning phase on safety and efficiency of laparoscopic fundoplication].
The introduction of laparoscopic techniques into surgical practice has required a learning process on the part of the surgeons involved. The duration, morbidity, and functional outcome of laparoscopic fundoplication were evaluated in our institution's first 146 cases. During a 34-month period the patients underwent laparoscopic Nissen (n = 102) or Toupet (n = 44) fundoplication. Conversion to open access was necessary in 7 cases, re-operation for complications in 2, all among the first 40 cases of the series. The median operating time was 165 min (range 75-375) in the first 40 cases, and 105 min (range 50-235) thereafter (P < 0.001). Body mass index, grade of esophagitis, and the surgeon's experience were independent predictors of the operating time. One hundred and thirty-four patients (92%) could be evaluated for recurrence of reflux, which was encountered in 2 (5%) of the first 40 cases and 8 (8%) of 94 patients in the later group.
Remzi
M
M
Abteilung für Allgemeinchirurgie, Universitätsklinik für Chirurgie, Wien.
Lenglinger
J
J
Erne
B
B
Bagmet
N
N
Függer
R
R
Bischof
G
G
Wrba
F
F
Jakesz
R
R
Miholic
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence; D004502:Education, Medical, Continuing; D005260:Female; D018662:Fundoplication; D013502:General Surgery / Q000193:education*; D006551:Hernia, Hiatal / Q000601:surgery*; D006801:Humans; D007318:Inservice Training; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies