Learning curve of laparoscopy-assisted gastrectomy using a standardized surgical technique and an established educational system

The learning curve of a trainee for laparoscopy-assisted gastrec-tomy in a high volume center, in which an educational system and a standardized laparo-scopic procedure are already established, remains unclear. The early surgical outcomes of the patients of two trainees were investigated. both trainees followed a training program where they performed at least 20 cases being the camera assistant, 20 cases being the first assistant, before performing the surgery as an operator. The average operation time, intra operative bleeding, the number of retrieved lymph nodes, and morbidity rate were 240.2 min, 45.7 ml, 35.4, and 13.0%, respectively. there was no learning curve effect observed except with the operation time of one trainee. In a high volume center with an established educational system, trainees could perform laparoscopy-assisted gastrectomy safely, although there might be a learning curve effect in operation time and the surgeries took longer operation time in trainee's initial cases.