Single-incision laparoscopic surgery as a teaching procedure: a single-center experience of more than 2100 procedures.

Wakasugi, Masaki; Tei, Mitsuyoshi; Omori, Takeshi; Anno, Kana; Mikami, Tsubasa; Tsukada, Ryo; Koh, Masahiro; Gakuhara, Atsushi; Furukawa, Kenta; Suzuki, Yozo; Masuzawa, Toru; Kishi, Kentaro; Tanemura, Masahiro; Akamatsu, Hiroki

PURPOSE 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.