Learning Curve of a Young Surgeon's Video-assisted Thoracic Surgery Lobectomy during His First Year Experience in Newly Established Institution

BACKGROUND The purpose of this paper is to present a guideline for beginning video-assisted thoracic surgery (VATS) lobectomy to junior surgeons, and to review the first year experience of a new surgeon performing VATS lobectomies who had not performed a VATS lobectomy unassisted during his training period. MATERIALS AND METHODS A young surgeon opened a division of general thoracic surgery at a medical institution. The surgeon had performed about 100 lobectomies via conventional thoracotomy during his training period, but had never performed a VATS lobectomy unassisted while under the supervision of an expert. After opening the division of general thoracic surgery, the surgeon performed a total of 38 pulmonary lobectomies for various pulmonary diseases from March 2009 to February 2010. All data were collected retrospectively. RESULTS There were 14 lobectomies via thoracotomy, 14 VATS lobectomies, and 10 cases of attempted VATS lobectomies that were converted to open thoracotomies. The number of VATS lobectomies increased from the second quarter (n=0) to the third quarter (n=5). The lobectomies that were converted from VATS into thoracotomies decreased from the second quarter (n=5) to the third quarter (n=1) (p=0.002). CONCLUSION It can take 6 months for young surgeons without experience in VATS lobectomy in their training period to be able to reliably perform a VATS lobectomy.