title: [The learning curve of video-assisted thoracoscopic surgery (VATS) for lung lobectomy--a single Israeli center experience].
abstract: BACKGROUND
  Video-assisted thoracoscopic surgery (VATS) is a method of lung lobe resection that has been implemented in medical centers worldwide since 1992. This procedure utilizes video equipment to assist in performing lobectomies without the need to open the chest wall As of 2009, VATS has been performed in the generaL thoracic surgery department of Rambam HeaLthcare Campus, Haifa. Since then, more than 200 patients were successfully operated on using this method. This study analyzed the Learning curve experienced by its surgeons and departmental staff since VATS implementation.
  
  
  METHODS
  Patient files for all cases which underwent VATS in the department from January 2009 to June 2010 were retrospectively evaluated. The patients were divided into three groups based on their operation date; each group included patients that were operated on during a half-year interval. Data was collected and compared between the groups in regard to the percentage of surgeries that used VATS versus procedures which involved opening the chest wall, procedure time, duration of hospital stay, conversion ratios for closed to open operations, and intra and post-operative complications. Subsequent results were then compared to those reported from other countries around the world.
  
  
  RESULTS
  VATS Lobectomies comprised the smallest percentage of the total Lobectomies performed in the department during the first 6 months of analysis (January 2009 - June 2009] as compared to the following year of analysis (July 2009 - June 2010), that involved a much more extensive use of VATS. The first 6 months of VATS implementation also involved fewer intra-operative complications and shorter operation times as compared to the following year. The length of stay and the number of post-operative complications were similar in each time interval analyzed.
  
  
  CONCLUSIONS
  VATS lobectomy requires surgeons and departmental staff to face a steep learning curve. Operators should invest 6-12 months usage of VATS and perform 30-60 operations in order to achieve constant results that are consistent with those reported from other medical centers worldwide.
authors: Bruce and Ruth Rappaport Faculty of Medicine, Technion, Haifa, Israel. aradtomer@gmail.com
authors: Tomer
authors: T
authors: Arad
authors: Dan
authors: D
authors: Levi-Faber
authors: Rony-Reuven
authors: RR
authors: Nir
authors: Ran
authors: R
authors: Kremer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D007557:Israel; D007902:Length of Stay; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013997:Time Factors