LEARNING CURVE OF LAPAROSCOPY-ASSISTED GASTRECTOMY USING A STANDARDIZED SURGICAL TECHNIQUE AND AN ESTABLISHED EDUCATIONAL SYSTEM

Background and Aims: The learning curve of a trainee for laparoscopy-assisted gastrectomy in a high volume center, in which an educational system and a standardized laparoscopic procedure are already established, remains unclear. Material and Methods: The early surgical outcomes of the patients of two trainees were investigated. Both trainees followed a training program where they performed at least 20 cases being the camera assistant, 20 cases being the first assistant, before performing the surgery as an operator. Results: The average operation time, intraoperative bleeding, the number of retrieved lymph nodes, and morbidity rate were 240.2 min, 45.7 ml, 35.4, and 13.0%, respectively. There was no learning curve effect observed except with the operation time of one trainee. Conclusions: In a high volume center with an established educational system, trainees could perform laparoscopy-assisted gastrectomy safely, although there might be a learning curve effect in operation time and the surgeries took longer operation time in trainee's initial cases.