ArticlePloS one2017
Learning curve for laparoscopic Heller myotomy and Dor fundoplication for achalasia.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Peroral endoscopic myotomy compared to laparoscopic Heller myotomy and pneumatic dilation in the treatment of achalasia: a systematic review.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2024Pooled it
- Circumferential Heller myotomy can relieve chest pain in patients with achalasia: a prospective clinical trial.Esophagus : official journal of the Japan Esophageal Society · 2020Trial
- Assessment of the learning curve for peroral endoscopic myotomy with fundoplication for a single operator.iGIE : innovation, investigation and insights · 2025Article
- Single-center experience of transitioning from video-assisted laparoscopic to robotic Heller myotomy with Dor fundoplication for esophageal motility disorders.BMC surgery · 2023Observational
- Mucosal injury during laparoscopic Heller cardiomyotomy: risk factors and impact on surgical outcomes.Surgery today · 2023Article
- Defining benchmarks for fellowship training in foregut surgery: a 10-year review of fellowship council index cases.Surgical endoscopy · 2022Article
- Laparoscopic Revisional Surgery After Failed Heller Myotomy for Esophageal Achalasia: Long-Term Outcome at a Single Tertiary Center.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Does laparoscopic reoperation yield symptomatic improvements similar to those of primary laparoscopic Heller myotomy in achalasia patients?Surgical endoscopy · 2021Article
- Overcoming the Arduous Transition for Robotic Hepatopancreatobiliary Cases: A Multi-Procedure Learning Curve Study Utilizing CUSUM Analysis.World journal of surgery · 2021Article
- Robotic and per-oral endoscopic myotomy have fewer technical complications compared to laparoscopic Heller myotomy.Surgical endoscopy · 2020Article
- Single incision laparoscopic fundoplication: A systematic review of the literature.World journal of gastrointestinal surgery · 2019Article
- A Thousand and One Laparoscopic Heller Myotomies for Esophageal Achalasia: a 25-Year Experience at a Single Tertiary Center.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2019Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAlthough laparoscopic Heller myotomy and Dor fundoplication (LHD) is widely performed to address achalasia, little is known about the learning curve for this technique. We assessed the learning curve for performing LHD.
methodsOf the 514 cases with LHD performed between August 1994 and March 2016, the surgical outcomes of 463 cases were evaluated after excluding 50 cases with reduced port surgery and one case with the simultaneous performance of laparoscopic distal partial gastrectomy. A receiver operating characteristic (ROC) curve analysis was used to identify the cut-off value for the number of surgical experiences necessary to become proficient with LHD, which was defined as the completion of the learning curve.
resultsWe defined the completion of the learning curve when the following 3 conditions were satisfied. 1) The operation time was less than 165 minutes. 2) There was no blood loss. 3) There was no intraoperative complication. In order to establish the appropriate number of surgical experiences required to complete the learning curve, the cut-off value was evaluated by using a ROC curve (AUC 0.717, p < 0.001). Finally, we identified the cut-off value as 16 surgical cases (sensitivity 0.706, specificity 0.646).
conclusionLearning curve seems to complete after performing 16 cases.
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