Training and Learning Curve in Minimally Invasive Rectal Surgery



Minimally invasive surgery has made dramatic improvement in patient outcomes. Acceptance and widespread use were slower in rectal surgery than colon surgery, due to the technical difficulties of operating in the pelvis, as well as questions of oncologic equivalence in early controlled trials. The current literature on learning and training concentrates more on colon than rectal surgery. However, available reports show learning minimally invasive rectal surgery is easier with a background in laparoscopic colon surgery. With increasing experience, there is a trend toward better short-term outcomes and more complex cases. Furthermore, there are no patient detriments along the learning curve. With new tools, training techniques, and an understanding of the learning curve, the benefits of minimally invasive rectal surgery can be realized. In this chapter, we review the tenets of a learning curve for minimally invasive surgery, distinctions between learning colon and rectal surgery, specific learning curves for several minimally invasive techniques, future direction, and training to perform minimally invasive rectal surgery efficiently and effectively.


Learning curve Minimally invasive surgery Rectal cancer Laparoscopic surgery Hand-assisted laparoscopic surgery Transanal minimally invasive surgery Robotic-assisted rectal resection Single-incision laparoscopic surgery 


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© Springer International Publishing Switzerland 2018

Open Access This chapter is distributed under the terms of the Creative Commons Attribution Noncommercial License, which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Authors and Affiliations

  1. 1.Colorectal Surgical Associates, LLPHoustonUSA
  2. 2.Division of Minimally Invasive Colon and Rectal Surgery, Department of SurgeryThe University of Texas Medical School at HoustonHoustonUSA

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