Mini-laparoscopy, laparoendoscopic single-site surgery and natural orifice transluminal endoscopic surgery-assisted laparoscopy: Novice surgeons'performance and perception in a porcine nephrectomy model

Carmelo Quattrone, Jorge Correia-Pinto, Estevão Lima, Riccardo Autorino, Carmelo Quattrone, Fernando J. Kim, Luigi Schips, Luca Cindolo, Marco De Sio, Pierluigi Bove, Evangelos Liatsikos, Jens Rassweiler, Abhay Rané, Rocco Damiano, Maria J. Ribal

Risultato della ricerca: Article

11 Citazioni (Scopus)

Abstract

OBJECTIVE • To evaluate the perception and performance of urological surgeons when first applying scarless surgical techniques. METHODS • The study was conducted during the 2 nd Minimally Invasive Urological Surgical Week annual course in Braga, Portugal. • Fourteen attendees performed three porcine nephrectomies by using each of the following techniques: mini-laparoscopy, laparoendoscopic single-site surgery (LESS) and natural orifice transluminal endoscopic surgery (NOTES)-assisted laparoscopy. • Peri-operative data were recorded, and operating performance was scored by one experienced surgeon for each working station, using a global rating scale. • The surgeons'subjective perceptions of degree of difficulty were graded and their expectations before the procedures were recorded. RESULTS • Forty-two porcine nephrectomies were performed. • There were no differences in overall operating time, or time to dissect and manage the renal vascular hilum, whereas time to gain access was faster for LESS than for mini-laparoscopy or NOTESassisted laparoscopy (mean [ SD ] 8 [ 6 ] min vs 10.2 [ 5.3 ] min vs 9.9 [ 5.3 ] min, respectively; P =0.59). • A better visualization of the surgical field was obtained with mini-laparoscopy and there was a higher degree of difficulty of bimanual dexterity for LESS, but no significant differences were found among the three techniques for any variable (operating field view: P =0.52; bimanual dexterity: P =0.49; efficiency: P =0.77; tissue handling: P =0.61; autonomy: P =0.2). • Subjective perception of the degree of difficulty trended in favour of minilaparoscopy ( P =0.17), but no significant difference was found in terms of surgeons ' impression as compared with their expectations ( P =0.34). CONCLUSIONS • When first approaching new scarless techniques, surgeons tend to perform equally well under expert guidance in the porcine model. • Mini-laparoscopy is perceived as less difficult to perform and, for all the techniques, surgeons'impressions are in line with their expectations. © 2012 THE AUTHORS.
Lingua originaleEnglish
pagine (da-a)991-996
Numero di pagine6
RivistaBJU International
Volume110
Stato di pubblicazionePublished - 2012

All Science Journal Classification (ASJC) codes

  • Urology

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