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How to reach proficiency in laparoscopic splenectomy?
September 16, 2009Laparoscopic splenectomy has become the gold standard intervention for the removal of the spleen, especially for benign causes. However, the organ's high anatomic location, fragility and generous blood supply makes the procedure an advanced laparoscopic operation. Furthermore, unlike patients with gall bladder stones, patients who need splenectomy for benign disorders are rare. These factors may prohibit the laparoscopic surgeon from becoming proficient in laparoscopic splenectomy. Measuring the expertise and setting a minimum number of procedures needed to be performed in order to be accepted as proficient in this rather rare operation has proved difficult.
A research team, led by Dr. Tarik Z. Nursal from the University of Baskent, has investigated the proficiency level reached in laparoscopic splenectomy procedures using the learning curve method. Their study will be published on August 28, 2009 in the World Journal of Gastroenterology.
In this study, all patients in need of splenectomy for benign causes in whom laparoscopic splenectomy was attempted by a single surgeon during a time period of 6 years were included in the study. Besides demographics, operation-related variables and the response to surgery were recorded. The patients were allocated to groups of five, ranked according to the date of the operation. Operation duration, complications, postoperative length of stay, conversion to laparotomy and splenic weight were then compared between these groups.
They found that unlike the widely accepted "L" shape, the learning curve for laparoscopic splenectomy was a horizontal lazy "S" with two distinct slopes. With the first 5 cases the novice may be granted privileges for performing laparoscopic splenectomy on an individual basis. Past the 25th case the surgeon could be accepted as an expert in the field.
World Journal of Gastroenterology
They found that unlike the widely accepted "L" shape, the learning curve for laparoscopic splenectomy was a horizontal lazy "S" with two distinct slopes. With the first 5 cases the novice may be granted privileges for performing laparoscopic splenectomy on an individual basis. Past the 25th case the surgeon could be accepted as an expert in the field.
World Journal of Gastroenterology
Splenectomy Current Events and Splenectomy News RSSLancet Study Supports New, Highly Effective Treatment for Blood Disorder
Patients suffering from a blood disorder that prevents proper clotting have the option of a new medication that may dramatically improve their health.
Novel therapeutic approaches may improve patient outcomes in several platelet disorders
Four studies that highlight significant advances in treatment and survival outcomes for patients with various forms of thrombocytopenia, a group of bleeding disorders characterized by a low number of platelets in the blood.
Avoiding Spleen Removal for Cooley's Anemia Sufferers
Researchers from Weill Cornell Medical College may have discovered the precise role of a gene in one of the world's most common blood disorders, beta-thalassemia, commonly known as Cooley's anemia.
Is the spleen able to prohibit tumor cell proliferation?
Primary and metastatic tumors of the spleen are described as unusual, excluding involvement by lymphoma. Indeed, isolated splenic metastasis from colorectal carcinoma is not a common occurrence. Its rareness has been hypothetically explained by several characteristics of the spleen, such as anatomical, histological and immunological features.
Mayo Clinic finds aggressive surgery best option for advanced-stage ovarian cancer patients
Mayo Clinic Cancer Center researchers report aggressive surgical removal of as much cancer as possible throughout the abdomen in ovarian cancer patients is the best option for most women.
Women face high risk of developing breast cancer following radiotherapy for Hodgkin’s Disease
Women who have received radiotherapy for Hodgkin’s Disease have a three times higher relative risk of developing breast cancer than women from the general population, Professor Dietlind Wahner-Roedler told the 3rd European Breast Cancer Conference today (Saturday 23 March). If the women were younger than 30 when they received the treatment their relative risk was even higher at eight times the normal risk. If the spleen had been removed from these younger women as part of the treatment (splenectomy), then they faced a ten times higher relative risk than the general population, while a family history of breast cancer increased their chances of developing the disease 11-fold above the ge
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