Learning curves in minimally invasive esophagectomy

Surgical innovation and pioneering are important for improving patient outcome, but can be associated with learning curves. Although learning curves in surgery are a recognized problem, the impact of surgical learning curves is increasing, due to increasing complexity of innovative surgical procedur...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2018-11, Vol.24 (44), p.4974-4978
Main Authors: van Workum, Frans, Fransen, Laura, Luyer, Misha Dp, Rosman, Camiel
Format: Article
Language:English
Subjects:
Esophageal Neoplasms - surgery
Esophagectomy - education
Esophagectomy - methods
Humans
Learning Curve
Minimally Invasive Surgical Procedures - education
Minimally Invasive Surgical Procedures - methods
Minireviews
Surgeons - education
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Summary:Surgical innovation and pioneering are important for improving patient outcome, but can be associated with learning curves. Although learning curves in surgery are a recognized problem, the impact of surgical learning curves is increasing, due to increasing complexity of innovative surgical procedures, the rapid rate at which new interventions are implemented and a decrease in relative effectiveness of new interventions compared to old interventions. For minimally invasive esophagectomy (MIE), there is now robust evidence that implementation can lead to significant learning associated morbidity (morbidity during a learning curve, that could have been avoided if patients were operated by surgeons that have completed the learning curve). This article provides an overview of the evidence of the impact of learning curves after implementation of MIE. In addition, caveats for implementation and available evidence regarding factors that are important for safe implementation and safe pioneering of MIE are discussed.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v24.i44.4974