title: Single-incision laparoscopic surgery as a teaching procedure: a single-center experience of more than 2100 procedures.
abstract: OBJECTIVE
  To confirm the safety and feasibility of single-incision laparoscopic surgery (SILS) and to compare the patient outcomes of single-incision laparoscopic surgery for laparoscopic appendectomy (SILS-LA) performed by resident doctors vs. staff surgeons.
  
  
  METHODS
  We performed a retrospective analysis of patients who underwent SILS between May, 2009 and May, 2015 at Osaka Police Hospital.
  
  
  RESULTS
  We analyzed 2172 patients. The operations performed consisted of cholecystectomy (n = 598), appendectomy (n = 202), inguinal hernia repair (n = 301), colorectal surgery (n = 673), and gastrectomy (n = 398). SILS was performed safely for a wide range of procedures with acceptable conversion and perioperative complication rates. The resident doctors in our department operated safely on 77 % (156/202) of patients undergoing SILS-LA. The staff surgeons operated on more elderly patients and patients with complicated appendicitis than did the resident doctors. The operative outcomes of the resident-performed SILS-LAs were better than those of the staff surgeons, although there was a patient selection bias.
  
  
  CONCLUSIONS
  SILS seems safe and feasible for a wide range of procedures. Based on our findings, we believe that SILS-LA could be a useful teaching procedure for resident doctors to perform on selected patients, under the guidance of an experienced staff surgeon.
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennouji-ku, Osaka, 543-0035, Japan. wakasugimasaki@gmail.com.
authors.forename: Masaki
authors.initials: M
authors.lastname: Wakasugi
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennouji-ku, 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, Tennouji-ku, Osaka, 543-0035, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Omori
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennouji-ku, 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, Tennouji-ku, 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, Tennouji-ku, 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, Tennouji-ku, 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, Tennouji-ku, Osaka, 543-0035, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Gakuhara
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennouji-ku, 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, Tennouji-ku, 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, Tennouji-ku, 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, Tennouji-ku, 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, Tennouji-ku, 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, Tennouji-ku, Osaka, 543-0035, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Akamatsu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000193:education* / Q000379:methods*; D002648:Child; D002763:Cholecystectomy / Q000193:education / Q000379:methods; D003107:Colorectal Surgery / Q000193:education / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000193:education / Q000379:methods; D006552:Hernia, Inguinal / Q000601:surgery; D059685:Herniorrhaphy / Q000193:education / Q000379:methods; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000193:education* / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D066231:Surgeons / Q000193:education*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Education; Laparoscopic appendectomy; Resident training; Single port; Single-incision laparoscopic surgery (SILS)