The Relationship Between the Number of Operations Performed and the Acquisition of Surgical Techniques in Endoscopic Dacryocystorhinostomy
Author: Ryo Nagaoka
Base Hospital / Institution: OCULO FACIAL CLINIC GROUP
ePoster presentation
Abstract ID: 24-384
Purpose
The surgical therapy for nasolacrimal duct obstruction, dacryocystorhinostomy (DCR), has become increasingly popular in recent years with endoscopic techniques (endoscopic dacryocystorhinostomy, E-DCR). To master this procedure, like any other surgery, it is necessary to accumulate surgical experience under the guidance of experienced physicians. However, facilities that perform E-DCR and provide guidance to inexperienced physicians are not as common. Therefore, the number of cases required to achieve proficiency in this procedure remains uncertain. In this report, we analyzed the surgical cases of physicians who started performing E-DCR at our institution.
Methods
From January 2018 to February 2024, we compared the progression of surgical times, recurrence rates, and complications for E-DCR performed by five physicians (A, B, C, D and E) who had not performed E-DCR surgeries outside our group, along with E-DCR surgeries performed by physician F (T.K) who had 15 years of surgical experience. For cases performed bilaterally, the total surgical time was divided by two to calculate the time for each side. Cases with concomitant lacrimal canaliculus atresia and cases using a Jones tube were excluded from the analysis.
Results
Each physician performed 41 (A), 34 (B), 29 (C), 20 (D), 9 (E) and 64 (F), respectively, totaling 133 procedures. To bring the surgical times of the other physicians closer to the average surgical time of physician F, which was 25 minutes and seemed to have reached a plateau, it required 40 cases for A, 25 cases for B, and 28 cases for C. D and E did not reach this average. There were no significant differences in complications or recurrence rates.
Conclusion
These findings suggest that acquiring proficiency in E-DCR requires a surgical experience of at least 25 to 40 cases within a specific timeframe.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Tomoyuki | Kashima | OCULO FACIAL CLINIC GROUP |
| Ryo | Kikuchi | OCULO FACIAL CLINIC GROUP |
