Impact of Japanese Society of Pediatric Surgeons-certified supervisors and patient factors on manipulation time during single-incision laparoscopic percutaneous extraperitoneal closure: a single-center retrospective study.

Abstract

Purpose: To assess the influence of supervisory surgeons certified by the Japanese Society of Pediatric Surgeons (JSPS) and patient-related factors on the manipulation time of single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC).

Methods: We retrospectively reviewed 469 SILPEC procedures that were performed between 2017 and 2023. Procedures were categorized based on whether or not the attending surgeons possessed JSPS certification as supervisors, and patient characteristics and manipulation time were compared. A multivariate analysis was also performed to evaluate the factors affecting manipulation time.

Results: In male patients, procedures attended by JSPS-certified supervisory surgeon had a shorter median (IQR) manipulation time (491.5 [396, 626.3] s) than those attended by non-certified surgeons (581 [445.3, 753] s; P = 0.0092). However, no significant difference was observed in female patients (367 [267.8, 623] vs. 399 [269.5, 593] s; P = 0.94). A multivariate analysis showed that, in males, attendance by a certified supervisor was associated with shorter manipulation times, whereas a history of hernia incarceration lengthened them. Furthermore, asymptomatic contralateral patent processus vaginalis repair was associated with shorter manipulation times in females.

Conclusion: Attendance by JSPS-certified supervisory surgeons significantly reduced manipulation time in male SILPEC cases. Considering patient background and procedural complexity, assigning JSPS-certified supervisory surgeons as attending surgeons may further enhance surgical efficiency.