title: Learning curve of laparoscopy-assisted gastrectomy using a standardized surgical technique and an established educational system.
abstract: OBJECTIVE
  The learning curve of a trainee for laparoscopy-assisted gastrectomy in a high volume center, in which an educational system and a standardized laparoscopic procedure are already established, remains unclear.
  
  
  METHODS
  The early surgical outcomes of the patients of two trainees were investigated. Both trainees followed a training program where they performed at least 20 cases being the camera assistant, 20 cases being the first assistant, before performing the surgery as an operator.
  
  
  RESULTS
  The average operation time, intraoperative bleeding, the number of retrieved lymph nodes, and morbidity rate were 240.2 min, 45.7 ml, 35.4, and 13.0%, respectively. There was no learning curve effect observed except with the operation time of one trainee.
  
  
  CONCLUSIONS
  In a high volume center with an established educational system, trainees could perform laparoscopy-assisted gastrectomy safely, although there might be a -learning curve effect in operation time and the surgeries took longer operation time in trainee's initial cases.
authors: Department of Gastroenterological Surgery, Cancer Institute Hospital, Tokyo, Japan.
authors: M
authors: M
authors: Tokunaga
authors: N
authors: N
authors: Hiki
authors: T
authors: T
authors: Fukunaga
authors: A
authors: A
authors: Miki
authors: S
authors: S
authors: Ohyama
authors: S
authors: S
authors: Miyata
authors: T
authors: T
authors: Yamaguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence; D005260:Female; D005743:Gastrectomy / Q000193:education* / Q000379:methods*; D006801:Humans; D007564:Japan; D010535:Laparoscopy / Q000193:education*; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome