Original ArticlesProficiency Level of Novice Technically Qualified Surgeons in Laparoscopic Rectal ResectionIchikawa, Nobuki PhD*; Homma, Shigenori PhD*; Yoshida, Tadashi PhD*; Iijima, Hiroaki MSc†; Kawamata, Futoshi PhD*; Sibasaki, Susumu PhD*; Kawamura, Hideki PhD*; Minagawa, Nozomi MD*; Kamiizumi, You MD‡; Fukasaku, Yasutomo MD*; Taketomi, Akinobu PhD*Author Information *Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University †Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo ‡Department of Surgery, Iwamizawa Municipal Hospital, Iwamizawa, Hokkaido Prefecture, Japan The author declares no conflicts of interest. Reprints: Shigenori Homma, PhD, Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, N-15, W-7, Kita-ku, Sapporo 060-8638, Hokkaido Prefecture, Japan (e-mail: [email protected]). Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: February 2020 - Volume 30 - Issue 1 - p 49-54 doi: 10.1097/SLE.0000000000000740 Buy Metrics Abstract The actual proficiency levels of surgeons after their qualification by the Endoscopic Surgical Skill Qualification System have not been established. This study aimed to investigate whether technically qualified surgeons could safely perform laparoscopic low anterior resection and to evaluate the proficiency level at the time of certification acquisition. A total of 46 patients (mean age, 63.3 y; male to female ratio, 29:17) who underwent low anterior resection were included. Outcomes of 46 low anterior resections for rectal cancer performed by 3 novice surgeons certified by the Endoscopic Surgical Skill Qualification System from 2013 to 2018 at 2 hospitals were retrospectively assessed. The mean operative time and blood loss were 201 minutes and 12.9 mL, respectively. One patient (2.2%) required conversion to open surgery, and major postoperative complications occurred in 4 patients (8.6%), including anastomotic leakage in 2 patients (4.3%). Histologic R0 resection was achieved in all cases. The operative time moving average for the 3 surgeons gradually decreased from 233 to 158 minutes. In cumulative sum charts, the operative time values continuously decreased after the 12th case compared with the target operative time (180 min). In conclusion, surgeons can safely perform laparoscopic low anterior resection just after their qualification but have the potential to further attain proficiency. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.