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master's thesis
LEARNING CURVE FOR LAPAROSCOPIC REPAIR OF PEDIATRIC INGUINAL HERNIA USING PERCUTANEOUS INTERNAL RING SUTURING
Split: University of Split, School of Medicine, 2021. urn:nbn:hr:171:281312
Huskic, Dario
University of Split
School of Medicine
Surgery

Cite this document

Huskic, D. (2021). LEARNING CURVE FOR LAPAROSCOPIC REPAIR OF PEDIATRIC INGUINAL HERNIA USING PERCUTANEOUS INTERNAL RING SUTURING (Master's thesis). Retrieved from https://urn.nsk.hr/urn:nbn:hr:171:281312

Huskic, Dario. "LEARNING CURVE FOR LAPAROSCOPIC REPAIR OF PEDIATRIC INGUINAL HERNIA USING PERCUTANEOUS INTERNAL RING SUTURING." Master's thesis, University of Split, School of Medicine, 2021. https://urn.nsk.hr/urn:nbn:hr:171:281312

Huskic, Dario. "LEARNING CURVE FOR LAPAROSCOPIC REPAIR OF PEDIATRIC INGUINAL HERNIA USING PERCUTANEOUS INTERNAL RING SUTURING." Master's thesis, University of Split, School of Medicine, 2021. https://urn.nsk.hr/urn:nbn:hr:171:281312

Huskic, D. (2021). 'LEARNING CURVE FOR LAPAROSCOPIC REPAIR OF PEDIATRIC INGUINAL HERNIA USING PERCUTANEOUS INTERNAL RING SUTURING', Master's thesis, University of Split, School of Medicine, accessed 24 May 2022, https://urn.nsk.hr/urn:nbn:hr:171:281312

Huskic D. LEARNING CURVE FOR LAPAROSCOPIC REPAIR OF PEDIATRIC INGUINAL HERNIA USING PERCUTANEOUS INTERNAL RING SUTURING [Master's thesis]. Split: University of Split, School of Medicine; 2021 [cited 2022 May 24] Available at: https://urn.nsk.hr/urn:nbn:hr:171:281312

D. Huskic, "LEARNING CURVE FOR LAPAROSCOPIC REPAIR OF PEDIATRIC INGUINAL HERNIA USING PERCUTANEOUS INTERNAL RING SUTURING", Master's thesis, University of Split, School of Medicine, Split, 2021. Available at: https://urn.nsk.hr/urn:nbn:hr:171:281312

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Metadata
TitleLEARNING CURVE FOR LAPAROSCOPIC REPAIR OF PEDIATRIC INGUINAL HERNIA USING PERCUTANEOUS INTERNAL RING SUTURING
Title (croatian)KRIVULJA UČENJA LAPAROSKOPSKE OPERACIJSKE TEHNIKE KORIŠTENJEM PERKUTANO UVEDENOG ŠAVA ZA ZATVARANJE UNUTARNJEG OTVORA PREPONSKOG KANALA U LIJEČENJU PREPONSKE KILE U DJECE
AuthorDario Huskic
MentorZenon Pogorelić (mentor)
Committee memberDavor Todorić (predsjednik povjerenstva)
Committee memberJoško Božić (član povjerenstva)
Committee memberDragan Krnić (član povjerenstva)
GranterUniversity of Split
School of Medicine
(Surgery)
Split
Defense date and country2021-07-26, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Surgery
Abstract
Background: Percutaneous internal ring suturing (PIRS) is a simple and popular technique for the treatment of inguinal hernia. The aim of this study was to analyze the learning curves during implementation of PIRS in our department. Methods: A total of 318 pediatric patients underwent hernia repair using the PIRS technique, by three pediatric surgeons with different levels of experience in laparoscopic surgery. These patients were enrolled in a prospective cohort study during the period of October 2015 until January 2021. Surgical times, intraoperative and postoperative complications plus outcomes of treatment were compared between the three surgeons with different levels of experience in laparoscopic surgery. Results: Regarding operative time a significant difference among the surgeons was found. Operative time significantly decreased after 25–30 procedures per surgeon. The surgeon with advanced experience in laparoscopic surgery had significantly less operative times for both unilateral (P=0.002) and bilateral (P=0.0001) hernia repair, compared to the other two surgeons. Perioperative complications, conversion, and ipsilateral recurrence rates were all higher in the beginning, reaching the benchmarks when each surgeon performed at least 30 PIRS procedures. The most experienced surgeon had the lowest number of complications (1.4%) and needed the fewest number of cases to reach the plateau. The other two surgeons with less experience in laparoscopic surgery had higher rates of complications (4.4% and 5.4%) and needed a higher number of cases to reach the plateau (P=0.190). Conclusion: A PIRS learning curve for perioperative and postoperative complications, recurrences, and conversion rates reached the plateau after each surgeon performed at least 30 cases. After that number was achieved, PIRS was shown to be a safe and effective approach for pediatric hernia repair. A Surgeon with an advanced level of experience in pediatric laparoscopic surgery adopted the technique more easily and had a significantly faster learning curve compared to the surgeons with less experience.
Abstract (croatian)
Ciljevi: PIRS (eng. Percutaneous internal ring suturing) je relativno jednostavna i popularna kirurška tehnika za liječenje preponske kile u djece. Cilj ovog istraživanja bio je analizirati krivulju učenja tijekom implementacije PIRS-a u našoj Klinici. Metode: Ukupno 318 djece s preponskom kilom koja su operirana PIRS tehnikom, uključeno je u prospektivno kohortno istraživanje u razdoblju od listopada 2015. do siječnja 2021. godine. Duljina trajanja operacijskog zahvata, intraoperacijske i poslijeoperacijske komplikacije, kao i ishodi liječenja uspoređeni su između tri dječja kirurga s različitim razinama iskustva u laparoskopskoj kirurgiji. Rezultati: Duljina trajanja operacijskog zahvata značajno se razlikovala između dječjih kirurga uključenih u studiju te se značajno smanjila nakon što je svaki kirurg izveo 25–30 operacijskih zahvata. Duljinu trajanja operacijskog zahvata u djece s jednostranom (P=0,002) i obostranom (P=0,0001) preponskom kilom bila je značajno kraća u kirurga s naprednim iskustvom u laparoskopskoj kirurgiji, u usporedbi s ostala dva kirurga. Intraoperacijske komplikacije, stopa konverzija, kao i stopa recidiva bili su veći u početku studije, da bi dosegli plato kada je svaki kirurg izveo najmanje 30 zahvata. Najiskusniji kirurg imao je najmanji broj komplikacija (1,4%) i trebao je manji broj operacijskih zahvata da bi dosegao plato. Ostala dva kirurga, s manje iskustva u laparoskopskoj kirurgiji, imala su veću stopu komplikacija (4,4% i 5,4%) i bio im je potreban veći broj operacijskih zahvata da bi dosegli plato (P=0,190). Zaključci: Krivulja učenja po pitanju prijeoperacijskih i poslijeoperacijskih komplikacija, stope recidiva i konverzija za PIRS tehniku dosegnula je plato nakon što je svaki kirurg izveo najmanje 30 operacijskih zahvata. Nakon što je svaki kirurg uklhučen u studiju dosegnuo taj broj, pokazalo se da je PIRS siguran i učinkovit operacijski pristup u liječenju preponske kile dječje dobi. Kirurg s naprednom razinom iskustva u dječjoj laparoskopskoj kirurgiji lakše je usvojio tehniku i imao je značajno bržu krivulju učenja u usporedbi s kirurzima koji su imali manju razinu iskustva u dječjoj laparoskopskoj kirurgiji.
Keywords
Keywords (croatian)
Languageenglish
URN:NBNurn:nbn:hr:171:281312
Study programmeTitle: Medical Studies in English
Study programme type: university
Study level: integrated undergraduate and graduate
Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
RepositoryMEFST Repository
Created on2021-07-27 12:05:28