Assessment of the learning curve of video-assisted thoracoscopic sympathectomy in a single neurosurgical trainee: a cumulative summation analysis

Egyptian Journal of Neurosurgery

Hazem M. Alkosha¹  Yasser M. Elkiran² 

[1] Department of Neurosurgery, Mansoura University Hospital, Gomhurria Street, Mansoura, Egypt;Department of Vascular Surgery, Mansoura University Hospital, Mansoura, Egypt;

关键词: Learning curve;    Sympathectomy;    Cumulative sum;    Thoracoscopy;   

DOI  :  10.1186/s41984-021-00122-0

来源: Springer

【 摘 要 】

BackgroundVideo-assisted thoracoscopic sympathectomy (VATS) is a common procedure unusually practiced by neurosurgeons due to lack of training.ObjectiveTo evaluate the learning curve for VATS in a young neurosurgeon with no previous experience in open sympathectomy techniques or extracranial endoscopic procedures.MethodsThis is a retrospective review and analysis of prospectively collected data in 50 consecutive cases admitted to our facility with the diagnosis of essential palmar and axillary hyperhidrosis operated by a neurosurgical trainee under strict supervision of 2 experienced mentors. After an initial training phase, cumulative sum mation (CUSUM) analysis was used to evaluate the surgical performance of the trainee in terms of operating time, blood loss, hospital stay and failures.ResultsImprovement in operating time was noticed after the first 20 cases with significant affection by changes in OR team. The blood loss was significantly improved after the first 10 cases with less sensitivity to changes in OR team. Hospital stay and failures were steady and within expected values throughout the study.ConclusionAn average of 20 cases may be enough for a neurosurgeon with basal knowledge to attain technical competence in VATS sympathectomy. Mentored surgical training on VATS sympathectomy is a safe and effective training method with failures within expected limits. The experience of the OR team plays an important role in the rapid improvement and consistency of performance.

【 授权许可】

CC BY