Surgical experience, workload and learning curve vs postoperative outcome.

Abstract

Aim: In this review, we look at the factor of the surgical experience and surgical workload in a variety of surgical disciplines and its effect on the intraoperative and postoperative complications rate.

Materials and methods: An extensive systematic electronic search was carried out on the relevant databases. Two independent reviewers were engaged in selecting appropriate articles in line with the protocol.

Results: It was very interesting to see that only 52 studies could be identified as per the inclusion criteria and search keywords. This included studies from 1990 onwards, spanning all surgical disciplines. Six studies were identified in third molar surgery, one of the most common surgeries practiced across all surgical disciplines. Seven appropriate oral implant surgery studies were identified, covering two-stage implants and immediately loaded implants. The evidence was overwhelming that the surgeon's experience positively correlates with the level of osseointegration and implant success. An interesting study from general surgery highlighted the fact it is not unusual to see senior surgeons selected to operate on complex patients or carry out complex surgical procedures than their junior colleagues. In face, this may explain why a number of studies identified no difference in the surgical complications between seniors and juniors.

Conclusions: Despite the fact that experience matters, many factors can influence the outcome of the surgery. If the surgeon, despite his/her lack of seniority, manages to utilise experience appropriately then there will be a beneficial outcome for the patient.