title: Single-incision totally extraperitoneal inguinal hernia repair as a teaching procedure: one center's experience of more than 300 procedures.
abstract: OBJECTIVE
  To evaluate resident doctors' proficiency in performing single-incision laparoscopic surgery for totally extraperitoneal inguinal hernia repair (SILS-TEP), and assess patient outcomes by comparing procedures performed by resident surgeons vs. those performed by staff surgeons.
  
  
  METHODS
  We analyzed retrospectively 301 patients who underwent SILS-TEP between January 2011 and May 2015 at Osaka Police Hospital.
  
  
  RESULTS
  The mean operative times for unilateral and bilateral hernia repairs in the resident-surgeon and the staff-surgeon groups were 99 vs. 88 min, respectively (p < 0.05), and 130 vs. 137 min, respectively. There was no significant difference in the incidence of conversion to a different procedure between the groups. The mean postoperative hospital stay was 2.0 days for patients from the resident-surgeon group vs. 2.8 days for those from the staff-surgeon group (p < 0.05). Seromas and wound infections developed in 8 % (12/148) of patients from the resident-surgeon group vs. 12 % (19/153) of those from the staff-surgeon group. No other major complications or hernia recurrence were noted in either group.
  
  
  CONCLUSIONS
  SILS-TEP was performed safely, with low morbidity and no recurrence, by the resident surgeons under appropriate guidance by staff surgeons.
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoujiku, Osaka, 543-0035, Japan. wakasugi@oph.gr.jp.
authors.forename: Masaki
authors.initials: M
authors.lastname: Wakasugi
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoujiku, Osaka, 543-0035, Japan.
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Tei
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoujiku, Osaka, 543-0035, Japan.
authors.forename: Kana
authors.initials: K
authors.lastname: Anno
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoujiku, Osaka, 543-0035, Japan.
authors.forename: Tsubasa
authors.initials: T
authors.lastname: Mikami
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoujiku, Osaka, 543-0035, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Tsukada
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoujiku, Osaka, 543-0035, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Koh
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoujiku, Osaka, 543-0035, Japan.
authors.forename: Kenta
authors.initials: K
authors.lastname: Furukawa
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoujiku, Osaka, 543-0035, Japan.
authors.forename: Yozo
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoujiku, Osaka, 543-0035, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Masuzawa
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoujiku, Osaka, 543-0035, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kishi
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoujiku, Osaka, 543-0035, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tanemura
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoujiku, Osaka, 543-0035, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Akamatsu
mesh_terms: D000368:Aged; D004503:Education, Medical, Graduate; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000193:education* / Q000379:methods*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies
keywords: Education; Inguinal hernia; Resident training; Single-incision laparoscopic surgery (SILS); Totally extraperitoneal repair (TEP)