Factors influencing operation time of laparoscopy-assisted distal subtotal gastrectomy: Analysis of consecutive 100 initial cases

Aims: There is little information on patient selection criteria for laparoscopy-assisted distal gastrectomy (LADG) that would facilitate a successful initial experience for a surgeon new to the procedure. This study aimed to establish patient selection criteria that will allow increased proficiency and shorter operation times for the LADG procedure. Method: One hundred LADG with lymphadenectomy and no other combined. procedures were consecutively performed by one surgeon. These 100 consecutive LADG procedures were analyzed retrospectively from a prospectively designed computer database. Uni- and multivariate analyses were performed to identify factors influencing operation time. Results: According to univariate analysis, operation time was influenced by sex, BMI, surgical experience, and tumor location, whereas multivariate analysis indicated that operation time was significantly influenced only by BMI and surgical experience. The same analyses of only the first 50 cases showed that sex, BMI, surgical experience, and tumor location were independently associated with operation time. As BMI increased, so did operation time, whereas operation time decreased with increasing surgical experience. Conclusion: This study suggests that surgeons who have limited experience with this advanced procedure may shorten operation time by considering patient and tumor characteristics in their early attempts at LADG. With a shortened operation time, surgeon with limited experience may become proficient to LADG rapidly. (c) 2006 Elsevier Ltd. All rights reserved.