title: Teaching Laparoscopic Adrenalectomy to Surgical Residents.
abstract: BACKGROUND
  Laparoscopic adrenalectomy is the surgical treatment for various adrenal diseases. The procedure is a common surgical practice for urologists and general surgeons and requires fundamental laparoscopic skills, nowadays common in the surgical education of residents in these practices. The aim of this study is to assess whether laparoscopic adrenalectomy differs in outcome between certified and trained surgeons and surgical residents and whether the learning curve changes the endpoint of the surgery.
  
  
  METHODS
  A cohort retrospective study, including all adult patients who underwent laparoscopic adrenalectomy between June 2008 and June 2014, was conducted. Patients' demographic, clinical, and surgical data were recorded and analyzed.
  
  
  RESULTS
  Fifty-three patients were included in the database (21 men, 32 women) with a mean age of 54 years (range 17-77). The cause for surgery was most commonly a benign adrenal tumor (27 patients, 50.9%) followed by large nonfunctioning adrenal tumors (16 patients, 30.1%), and adrenal cancer (8 patients, 15%). Eighteen patients (33.9%) were operated by residents (4-6 years into the residency) and 35 patients by a certified senior surgeon (66.1%). Left-sided adrenalectomy was preferred to right-sided adrenalectomy for resident tutoring (P = .03). Overall, intraoperative complications were seen in 6 patients (11.3%) and postoperative complications were seen in 9 patients (16.9%). There were no differences in operation time (P = .36), intraoperative complications (P = .76), postoperative complications (P = .96), and length of stay (P = .34) between the patients operated by senior residents and certified surgeons.
  
  
  CONCLUSIONS
  Laparoscopic adrenalectomy is a complex surgical procedure that should be a part of the surgical training of surgery residents, as it is safe in guided hands.
authors.affiliation: 1 Department of Surgery and Transplantation B, Chaim Sheba Medical Center , Ramat Gan, Israel .|2 Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .
authors.forename: Nir
authors.initials: N
authors.lastname: Horesh
authors.affiliation: 1 Department of Surgery and Transplantation B, Chaim Sheba Medical Center , Ramat Gan, Israel .|2 Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .
authors.forename: Harel
authors.initials: H
authors.lastname: Jacoby
authors.affiliation: 1 Department of Surgery and Transplantation B, Chaim Sheba Medical Center , Ramat Gan, Israel .|2 Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .
authors.forename: Yael
authors.initials: Y
authors.lastname: Dreznik
authors.affiliation: 1 Department of Surgery and Transplantation B, Chaim Sheba Medical Center , Ramat Gan, Israel .|2 Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .
authors.forename: Roy
authors.initials: R
authors.lastname: Nadler
authors.affiliation: 1 Department of Surgery and Transplantation B, Chaim Sheba Medical Center , Ramat Gan, Israel .|2 Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .
authors.forename: Imri
authors.initials: I
authors.lastname: Amiel
authors.affiliation: 2 Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .|3 Department of Urology, Chaim Sheba Medical Center , Ramat Gan, Israel .
authors.forename: Zohar A
authors.initials: ZA
authors.lastname: Dotan
authors.affiliation: 1 Department of Surgery and Transplantation B, Chaim Sheba Medical Center , Ramat Gan, Israel .|2 Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .
authors.forename: Mordechai
authors.initials: M
authors.lastname: Gutman
authors.affiliation: 1 Department of Surgery and Transplantation B, Chaim Sheba Medical Center , Ramat Gan, Israel .|2 Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .
authors.forename: Moshe
authors.initials: M
authors.lastname: Shabtai
authors.affiliation: 1 Department of Surgery and Transplantation B, Chaim Sheba Medical Center , Ramat Gan, Israel .|2 Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .
authors.forename: Danny
authors.initials: D
authors.lastname: Rosin
mesh_terms: D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000193:education* / Q000379:methods*; D000328:Adult; D000368:Aged; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology; D007557:Israel; D010535:Laparoscopy / Q000193:education*; D059032:Learning Curve; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult