Evidence map›Paper›PMID 23073688›Full record

SynthesisSurgical endoscopy2013

Have we learned from lessons of the past? A systematic review of training for single incision laparoscopic surgery.

Philip H Pucher, Mikael H Sodergren, Pritam Singh, Ara Darzi, Paraskevas Parakseva

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Trial
  5. [Operation time for suprapubic transumbilical cholecystectomy: Results of a prospective randomized trial].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2015
    Trial
  6. Trial
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Influencing factors for port-site hernias after single-incision laparoscopy.Hernia : the journal of hernias and abdominal wall surgery · 2016
    Article
  15. Article
  16. Article
  17. Review
  18. Review
  19. Single-Incision Laparoscopic Colon and Rectal Surgery.Clinics in colon and rectal surgery · 2015
    Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Philip H PucherDepartment of Surgery and Cancer, Imperial College London, St. Mary's Hospital, 10th Floor QEQM, South Wharf Road, Paddington, London W2 1NY, UK. p.pucher@imperial.ac.uk
Mikael H Sodergren
Pritam Singh
Ara Darzi
Paraskevas Parakseva

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSingle incision laparoscopic surgery (SILS) represents the next step in laparoscopic surgery in further reducing the invasiveness of surgical procedures with cosmetic advantages. Recalling the increased rates of major complications at the advent of laparoscopic cholecystectomy 20 years ago, however, it is clear that appropriate training is required before adopting a new technique. This study aims to review the current evidence for training and skills acquisition for SILS.

methodsA comprehensive database search of PubMED, MEDLINE, EMBASE and Google Scholar was carried out. Studies considered for inclusion were those addressing SILS learning curves, skills acquisition, or training.

results21 studies were included in the final analysis. Ten clinical case series with analysis of SILS learning curve demonstrated a significant learning curve for conventional multiport laparoscopic (LAP)-trained surgeons over the course of initial SILS cases, with several studies reporting increased risk of conversion and complication rates. Five laboratory-based studies demonstrated differences in SILS skills acquisition compared with LAP. Six studies describing SILS-specific training curricula were analysed, but none included a robust validation of the curriculum.

conclusionsClinical case series and laboratory-based skills acquisition studies demonstrate the unique requirements of SILS, with skill sets and ergonomic demands which cannot be directly adapted from existing LAP experience. Some studies have already reported higher complication rates in initial SILS cases. To avoid repeating the mistakes of the past, the implementation of an evidence- and competency-based SILS curriculum is necessary to ensure appropriate training of future SILS surgeons.

Indexed as

Cholecystectomy, LaparoscopicClinical CompetenceCurriculumErgonomicsEvidence-Based PracticeHumansLaparoscopyLearning CurveMotor SkillsRetrospective StudiesTreatment Outcome

Identifiers

PMID23073688

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.