Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jun 16, 2022; 14(6): 387-401
Published online Jun 16, 2022. doi: 10.4253/wjge.v14.i6.387
Change point analysis validation of the learning curve in laparoscopic colorectal surgery: Experience from a non-structured training setting
Konstantinos Perivoliotis, Ioannis Baloyiannis, Ioannis Mamaloudis, Georgios Volakakis, Alex Valaroutsos, George Tzovaras
Konstantinos Perivoliotis, Ioannis Baloyiannis, Ioannis Mamaloudis, Georgios Volakakis, Alex Valaroutsos, George Tzovaras, Department of Surgery, University Hospital of Larissa, Larissa 41110, Greece
Author contributions: Perivoliotis K, Baloyiannis I, and Tzovaras G designed the research study; Mamaloudis I, Volakakis G, and Valaroutsos A acquired the study data; Perivoliotis K and Baloyiannis I drafted the manuscript; Baloyiannis I and Tzovaras G critically revised and approved the final manuscript.
Institutional review board statement: This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. We consulted extensively with the IRB of University Hospital of Larissa who determined that our study did not need ethical approval since all procedures being performed were part of the routine care.
Informed consent statement: Informed consent was obtained from all individual participants included in the study.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: The datasets generated during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Ioannis Baloyiannis, MD, PhD, Assistant Professor, Department of Surgery, University Hospital of Larissa, Viopolis, Larissa 41110, Greece.
Received: January 24, 2022
Peer-review started: January 24, 2022
First decision: April 17, 2022
Revised: April 23, 2022
Accepted: May 17, 2022
Article in press: May 17, 2022
Published online: June 16, 2022
Research background

The introduction of structured training programs results in an enhanced learning process in laparoscopic colorectal surgery.

Research motivation

National training programs are not widely available, thus constraining the efficient adaptation of minimal invasive techniques in colorectal surgery.

Research objectives

To analyze the learning curve patterns in laparoscopic colorectal operations under a non-structured training setting.

Research methods

A retrospective analysis of a prospectively collected database was performed. Cumulative sum analysis and change point analysis were introduced for the evaluation of learning curve patterns.

Research results

In terms of operation duration, three learning curve phases were identified. A learning curve pattern was also confirmed in pathology endpoints, but not in the open conversion and complications outcomes.

Research conclusions

Laparoscopic colorectal operations under a non-structured training setting result in similar learning patterns with the respective structured training curves.

Research perspectives

The introduction of formal training programs in laparoscopic colorectal surgery is necessary for the safer and wider adoption of these techniques.