ArticleSurgical endoscopy2017
Learning curve takes 65 repetitions of totally extraperitoneal laparoscopy on inguinal hernias for reduction of operating time and complications.
Article in Surgical endoscopy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 4 of them syntheses that pooled it.
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Who cites it
35 citing papers in PubMed, 4 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- Learning curve of laparoscopic inguinal hernia repair: systematic review, meta-analysis, and meta-regression.Surgical endoscopy · 2023Pooled it
- The development of laparoscopic skills using virtual reality simulations: A systematic review.PloS one · 2021Pooled it
- State of the art: open mesh-based inguinal hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2019Pooled it
- Current status of single-port versus multi-port approach in laparoscopic inguinal hernia mesh repair: an up-to-date systematic review and meta-analysis.Hernia : the journal of hernias and abdominal wall surgery · 2019Pooled it
- 3D Versus 4K Display System - Influence of "State-of-the-art"-Display Technique on Surgical Performance (IDOSP-study) in Minimally Invasive Surgery: A Randomized Cross-over Trial.Annals of surgery · 2020Trial
- Comparison of early and long term outcomes of open Lichtenstein repair and totally extraperitoneal herniorrhaphy for primary inguinal herniasTurkish journal of medical sciences · 2019Trial
- Stress responses and experiences of surgical trainees in simulation-based training of advanced laparoscopic procedures in highly realistic environments.Advances in simulation (London, England) · 2026Article
- Diverse surgical techniques for laparoscopic transumbilical intraperitoneal suturing of the internal ring in male pediatric patients.Scientific reports · 2025Article
- The mentoring effects of learning curve of total extraperitoneal hernioplasty: the CUSUM analysis of the pioneer and second-generation surgeon.Surgical endoscopy · 2025Article
- Article
- Application of the laparoscopic auxiliary needle device in the treatment of pediatric inguinal hernia: an eight-year experience.Surgical endoscopy · 2025Article
- Robotic minimally invasive inguinal hernia repair with the Dexter robotic system™: A prospective multicenter clinical investigation.Surgical endoscopy · 2024Article
- Learning and implementation of TransREctus sheath PrePeritoneal procedure for inguinal hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- Modeling of Learning Processes Using Continuous-Time Markov Chain for Virtual-Reality-Based Surgical Training in Laparoscopic Surgery.IEEE transactions on learning technologies · 2024Article
- Article
- A novel laparoscopic inguinal hernia repair technique: single-port lateral non-abdominal pre-peritoneal approach.Langenbeck's archives of surgery · 2023Article
- Learning curve analysis using the cumulative summation method for totally extraperitoneal repair of the inguinal hernia.Langenbeck's archives of surgery · 2022Article
- Proctored preceptorship model for learning eTEP repair for inguinal hernia for general surgery residents.Hernia : the journal of hernias and abdominal wall surgery · 2022Article
- Fellowship training influences learning curves for laparoscopic sleeve gastrectomy.Surgical endoscopy · 2022Article
- Learning curve of robotic-assisted transabdominal preperitoneal repair (rTAPP) for inguinal hernias.Surgical endoscopy · 2021Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInguinal hernia repair is one of the most frequently conducted surgical procedures worldwide. Totally extraperitoneal (TEP) hernioplasty has shown many advantages over traditional open surgery. However, because of increased surgical complexity, it requires more practice to achieve optimal results.
objectivesThe aim of this study is to evaluate the learning curve for TEP hernioplasty, analysing parameters related to the mean operating time. The secondary objective is to assess the complications and early discharge rates related to this procedure.
methodsA prospective study of 238 consecutive patients undergoing TEP hernioplasty from the same practitioner between May 2009 and May 2014, in a specialised centre for abdominal hernias in Sao Paulo, Brazil, was conducted. All data were obtained through medical records.
resultsThe study included 137 patients undergoing a total of 157 TEP hernia repairs. Bilaterality and complications can influence the operating time and so were excluded. Patients with unilateral surgery and without complications were included. Patients were chronologically divided into four groups. Groups 1-3 were composed of 35 patients and group 4 of 32. There were no significant variations in clinical characteristics between the groups. The plateau of the learning curve was reached on the 65 th repetition of the surgery, with a mean operating time of 28 min (p < 0,05). Complications were only observed in the first group of 35 patients. 97% of patients were discharged early, defined as patient leaving hospital less than 12 h after surgery.
conclusionAfter an initial reduction, the mean operating time stabilised after 65 cases. A reduction in the rate of complications was observed after 35 cases, and a rate of 97% of early discharge was achieved.
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Registered trials
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.