The impact of laparoscopic fellowship programme on laparoscopic nephrectomy experience: A brief report

Objective: To evaluate the impact of 3-month laparoscopic fellowship programme (LFP) on the laparoscopy experience mainly related to laparoscopic nephrectomies. Materials and methods: Between September 2005 and June 2009, 131 patients underwent laparoscopic nephrectomy (LN). Groups 1 (n=87) and 2 (n=44) were defined as patients who underwent laparoscopic operation before and after LFP taken by the attending surgeon. All data were retrospectively reviewed. Results: There was no statistically significant difference in age, body mass index or ASA (American Society of Anesthesiologists) score between the two groups. Group 2 yielded a significantly shorter mean operative time (134.82±63.69 min vs. 110.75±36.68 min, p=0.028), lower estimated blood loss (283.56±412.97 mL vs. 115.68±123.54 mL, p<0.005), lower hematocrit drop (4.10±2.69% vs. 2.59±3.28%, p=0.006), and shorter hospital stay (3.94±2.52 days vs. 3.11±2.67 days, p<0.002). The incidence of retroperitoneal approach was higher in Group 2 compared to Group 1 (90.9% vs. 29.9%, p<0.005). Additionally, the rate of performing LN by trainee's was significantly higher in Group 2 (3.4% vs. 20.5%, p=0.003). Conclusion: Since a mentor transfers his/her experience to a trainee in LFP, perioperative outcomes improve eventually. Therefore, it is worth attending to a LFP even if a surgeon has a laparoscopy experience. Moreover, LFP is an indispensable step encouraging interventions for more complicated laparoscopic cases.