JSLS : Journal of the Society of Laparoendoscopic Surgeons
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Comparative Study
Laparoscopic colectomy: does the learning curve extend beyond colorectal surgery fellowship?
As minimally invasive colon and rectal resection has become increasingly prevalent over the past decade, the role that fellowship training plays has become an important question. This analysis examines the learning curve of one fellowship-trained colorectal surgeon in his first 100 cases. ⋯ Prior investigators have demonstrated a significant learning curve for laparoscopic colorectal surgery. In the first 100 cases, there is no difference in mortality or morbidity between early and late cases. Alternatively, operative times decreased with experience. Laparoscopic training during CRS fellowship surpasses the learning curve in regard to safety and outcome, whereas operative efficiency improves over the first year of practice.
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Intrauterine device (IUD) migration and colon perforation is a rare but serious complication occurring sometimes years after insertion. Laparoscopic removal of a colon-perforating device is a seldom-used approach. ⋯ Clinical diagnosis and surgical removal of a perforating intrauterine device reduces the possible risks of abdominal complications this condition presents. In select cases, the laparoscopic approach for intrauterine device removal may be a simple and safe approach, thus minimizing possible postoperative complications.