This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (112)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

William A. See, MD; Christopher S. Cooper, MD; Ronald J. Fisher, MD

JAMA. 1993;270(22):2689-2692.

Abstract
Objective.
—To evaluate the relationship between laparoscopic complication rates and surgeon-dependent variables following a laparoscopic training course.

Design.
—Participants were surveyed regarding their interval laparoscopic experience 3 months and 12 months after the course.

Participants.
—Course participants/survey respondents represented a cross section of urologic surgeons in the United States. A total of 181 individuals (61% of 297 participants) completed and returned the 3-month questionnaire. A total of 128 surgeons responded to the 12-month questionnaire (78.5% of 163 participants).

Main Outcome Measure.
—Logistic regression analysis tested the relationship between surgeons' complication rates and study variables.

Results.
—At 3 months, surgeons who performed clinical procedures without additional training were 3.39 times more likely to have at least one complication compared with surgeons who sought additional training (P=.03). At 12 months, surgeons who had attended the training course alone, were in solo practice, or performed laparoscopic surgery with a variable assistant were 4.85, 7.74, and 4.80 times more likely, respectively, to have had a complication than their counterparts who attended the course with a partner, were in group practice, or operated with the same assistant (P=.004, P=.0008, and P=.0015, respectively). At both 3 and 12 months, laparoscopic complication rates of individual surgeons demonstrated a significant inverse correlation with the number of laparoscopic procedures performed.

Conclusions.
—The rate of complications associated with the clinical learning curve can be decreased by additional education following an initial course in laparoscopy. An ongoing clinical association with surgeons performing similar procedures decreases long-term complication rates.

(JAMA. 1993;270:2689-2692)

Author Affiliations
From the Department of Urology, University of Iowa Hospitals and Clinics, Iowa City.

Footnotes
Reprints not available.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Rate of undesirable events at beginning of academic year: retrospective cohort study
Haller et al.
BMJ 2009;339:b3974-b3974.
ABSTRACT | FULL TEXT  

The robotic surgery era and the role of laparoscopy training
Abaza
Therapeutic Advances in Urology 2009;1:161-165.
ABSTRACT  

The Role of the Assistant in Laparoscopic Surgery: Important Considerations for the Apprentice-in-Training
Chiu et al.
SURG INNOV 2008;15:229-236.
ABSTRACT  

Performance analysis of interactive multimodal CME retraining on attitude toward and application of OPCAB
Albert et al.
J. Thorac. Cardiovasc. Surg. 2006;131:154-162.
ABSTRACT | FULL TEXT  

Ethical and Educational Considerations in Minimally Invasive Surgery Training for Practicing Surgeons
Rogers
SURG INNOV 2002;9:206-211.
ABSTRACT  

Training of providers in embryo transfer: what is the minimum number of transfers required for proficiency?
Papageorgiou et al.
Hum Reprod 2001;16:1415-1419.
ABSTRACT | FULL TEXT  

The Learning Curve for Laparoscopic Hernia Repair
Wright and O'Dwyer
SURG INNOV 1998;5:227-232.
ABSTRACT  

Early Experience And Learning Curve Associated With Laparoscopic Nissen Fundoplication
Deschamps et al.
J. Thorac. Cardiovasc. Surg. 1998;115:281-285.
ABSTRACT | FULL TEXT  

The Impact of Surgical Complications After Liver Transplantation on Resource Utilization
Brown et al.
Arch Surg 1997;132:1098-1103.
ABSTRACT  

The Learning Curve for Laparoscopic Colorectal Surgery: Preliminary Results From a Prospective Analysis of 1194 Laparoscopic-Assisted Colectomies
Bennett et al.
Arch Surg 1997;132:41-44.
ABSTRACT  

Laparoscopic Herniorrhaphy: Diagnostic and Therapeutic Technology Assessment (DATTA)
Jacoby and Brodie
JAMA 1996;275:1075-1082.
ABSTRACT  

CHANGING THE LEARNING CURVE FOR LAPAROSCOPIC SURGERY
JWatch General 1993;1993:3-3.
FULL TEXT  

Credentialing in an Era of Change
Grundfest
JAMA 1993;270:2725-2725.
ABSTRACT