Objective:

To evaluate the impact of scopist experience on perioperative outcomes in laparoscopic liver resection (LLR) and to investigate whether the type of flexible 3D laparoscope controller affects operative performance and learning curve patterns.

Approach:

• Cohort Definition: 161 LLR cases were analyzed, excluding laparoscopic living donor hepatectomy, cases performed with scopists who had more than 1 year of training, prior hepatectomy, Child–Pugh class B or C, and concurrent extrahepatic abdominal surgery.

Key Findings:

• Expert scopists demonstrated better perioperative outcomes compared to beginner scopists, with statistically significant differences in operation time and estimated blood loss.
• The type of laparoscope controller (dual-lever vs joystick) influenced the performance and learning curve of scopists.
• Temporal trends indicated that operation times improved for both expert and beginner groups with increasing case experience.

Interpretation:

The study evaluates the impact of scopist experience and the type of laparoscope controller on operative performance and learning curves during LLR.

Limitations:

• The study was retrospective and conducted at a single institution, which may limit generalizability.
• Exclusion criteria may have introduced selection bias, affecting the representativeness of the findings.

Conclusion:

The findings indicate that both experience and technology design are associated with the learning curve of laparoscopic liver resection.