The Learning Curve for Laparoscopic Colorectal Surgery
Archives of SurgeryPublished 1 January 1997
Charles L. Bennett
Citations301
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TL;DR
There is a learning curve for laparoscopic-assisted colectomy with respect to intraoperative and postoperative outcomes, and surgeons who perform higher volumes of laparoscopically have lower rates of intraoperativeand postoperative complications.
Abstract
There is a learning curve for laparoscopic-assisted colectomy with respect to intraoperative and postoperative outcomes. As with other laparoscopic procedures, surgeons who perform higher volumes of laparoscopic-assisted colectomy have lower rates of intraoperative and postoperative complications.
Keywords
Medicine
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