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Purpose <p>The aim of the study was to evaluate operative time and postoperative complications of 4 post-training specialized surgeons.</p> Methods <p>This was a pilot retrospective chart review to determine the learning curve of a Shouldice primary inguinal hernia repair (Shouldice Repair) of 4 post-training specialized surgeons, at the Shouldice Hospital. The first 300 Shouldice Repairs (early learning block) were compared to their 900-1,000 repairs as the primary operating surgeon (late learning block). Data was collected from the hospital’s database. The learning curve was examined using cumulative sum analysis (CUSUM).</p> Results <p>During the early learning block cases, the surgeons had a mean operating time of 59.2 ± 11.2&#xa0;min. The late learning block cases had significantly reduced operative time (53.4 ± 10.5&#xa0;min, <i>p</i> = 0.001). According to the CUSUM analysis all four surgeons had a plateau after 78 to 88 operations in terms of operative time. A nonsignificant reduction in the rate of reported recurrences (<i>n</i> = 16 vs. <i>n</i> = 0) and surgical site occurrences (haematoma, seroma, infection; <i>n</i> = 27 vs. <i>n</i> = 2) was found between the early and late learning block cases.</p> Conclusion <p>The operating time plateaued after 78–88 Shouldice Repairs for the 4 surgeons trained and working at the Shouldice Hospital. A nonsignificant trend towards fewer complications were noted among late learning block cases.</p>

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The learning curve for the Shouldice Repair: a pilot analysis of post-training specialized surgeons at the Shouldice Hospital

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年1月23日

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  • Christoph Paasch,
  • Richard Hunger,
  • Peter Szasz,
  • Ayse Yilbas,
  • Fernando A. C. Spencer Netto,
  • Rene Mantke,
  • Marguerite Mainprize

摘要

Purpose

The aim of the study was to evaluate operative time and postoperative complications of 4 post-training specialized surgeons.

Methods

This was a pilot retrospective chart review to determine the learning curve of a Shouldice primary inguinal hernia repair (Shouldice Repair) of 4 post-training specialized surgeons, at the Shouldice Hospital. The first 300 Shouldice Repairs (early learning block) were compared to their 900-1,000 repairs as the primary operating surgeon (late learning block). Data was collected from the hospital’s database. The learning curve was examined using cumulative sum analysis (CUSUM).

Results

During the early learning block cases, the surgeons had a mean operating time of 59.2 ± 11.2 min. The late learning block cases had significantly reduced operative time (53.4 ± 10.5 min, p = 0.001). According to the CUSUM analysis all four surgeons had a plateau after 78 to 88 operations in terms of operative time. A nonsignificant reduction in the rate of reported recurrences (n = 16 vs. n = 0) and surgical site occurrences (haematoma, seroma, infection; n = 27 vs. n = 2) was found between the early and late learning block cases.

Conclusion

The operating time plateaued after 78–88 Shouldice Repairs for the 4 surgeons trained and working at the Shouldice Hospital. A nonsignificant trend towards fewer complications were noted among late learning block cases.