Category: Laparoscopic/ Robotic: Other
Introduction & Objective : The laparoscopicapproach to the adrenal gland has evolved to be the universal standard for most cases of adrenal conditions requiring surgical treatment. There is general consent about the safety, efficacy, and reproducibility of laparoscopicadrenal surgery. The procedure is a common surgical practice for urologists and requires fundamental laparoscopicskills, nowadays common in the surgical education of residents in these practices. The aim of this study is to assess the technical difficulties by training surgeons and which parameters influence the operating time.
Methods : We reviewed the medical records of 118 patients who underwent laparoscopic adrenorectomy by trained surgeon from 2010 to 2017 at our institution. Preoperative parameters (age, sex, BMI, adrenal neoplasm characterics, tumor size) were investigated. These parameters were simply obtained from the medical records. We evaluated the impact of these parameters on technical difficulties encountered during laparoscopic adrenorectomy by measuring operating time.
The operating time of larger tumor( ≧5cm ) or the characteristics of pheochromocytoma were prolonged compared with smaller tumor ( P= 0.0042 or 0.0013 ). Moreover tumor size wrere positively correlated with operating time( P= 0.0013 ) Multivariate analysis showed that tumor size was an independent risk factor for prolonged operating time ( P = 0.0199, odds ratio; 4.795 ), whereas BMI was not found to be a risk factor.
Conclusions : Larger tumor size and the characteristics as pheochromocytoma influenced the operating time for training surgeon. The identification of the factor of technical difficulty by evaluating operating time for training surgeon may lead to better understanding of laparoscopic teaching technics .
Masaya Yonemori– resident, Kagoshima University, Kagoshima, Kagoshima, Japan
Shuichi Tatarano– Assistant professor, Department of Urology, Kagoshima University, Kagoshima, Kagoshima, Japan
Hideki Enokida– Kagoshima University, Kagoshima, Kagoshima, Japan
Masayuki Nakagawa– Kagoshima University, Kagoshima, Kagoshima, Japan
Hirofumi Yoshino– , Kagoshima, Japan
Toshihiko Itesako– , Kagoshima, Japan
Department of Urology, Kagoshima University
Kagoshima, Kagoshima, Japan
Shuichi Tatarano, M.D., Ph.D.
Associate professor, Department of Urology, Kagoshima University