BACKGROUND: Increasing numbers of laparoscopic surgeons are performing laparoscopic Roux-en-Y gastric bypass (LGB). Our aim was to determine the length of the learning curve for a skilled laparoscopic surgeon. METHODS: The study population consisted of the first 225 consecutive LGB procedures attempted by one laparoscopic surgeon (HJS). Outcome parameters included mortality, morbidity, operative time, and conversion to an open procedure. RESULTS: Average operative time decreased from 189 min (first 75 patients) to 125 minutes (last 75 patients). Most of the improvement in operative time occurred over the first 75 patients. The perioperative complication rate decreased from 32% (first 75 patients) to 15% (second and third groups of 75 patients). Complication rates did not significantly decrease after the first 75 patients. Low mortality and conversion rates were achieved early in the series. CONCLUSION: Low mortality rates and low conversion rates can be achieved early in the learning curve for LGB. Complication rates plateau after approximately 75 LGBs, and operative times decrease substantially over the initial 75 cases. Operative times continue to decrease at a slower rate beyond 75 cases.
BACKGROUND: Increasing numbers of laparoscopic surgeons are performing laparoscopic Roux-en-Y gastric bypass (LGB). Our aim was to determine the length of the learning curve for a skilled laparoscopic surgeon. METHODS: The study population consisted of the first 225 consecutive LGB procedures attempted by one laparoscopic surgeon (HJS). Outcome parameters included mortality, morbidity, operative time, and conversion to an open procedure. RESULTS: Average operative time decreased from 189 min (first 75 patients) to 125 minutes (last 75 patients). Most of the improvement in operative time occurred over the first 75 patients. The perioperative complication rate decreased from 32% (first 75 patients) to 15% (second and third groups of 75 patients). Complication rates did not significantly decrease after the first 75 patients. Low mortality and conversion rates were achieved early in the series. CONCLUSION: Low mortality rates and low conversion rates can be achieved early in the learning curve for LGB. Complication rates plateau after approximately 75 LGBs, and operative times decrease substantially over the initial 75 cases. Operative times continue to decrease at a slower rate beyond 75 cases.
Authors: Markus Weber; Markus K Müller; Jean-Marie Michel; Rahim Belal; Fritz Horber; Renward Hauser; Pierre-Alain Clavien Journal: Ann Surg Date: 2003-12 Impact factor: 12.969
Authors: Nasser Sakran; Ahmad Assalia; Ahud Sternberg; Yoram Kluger; Anton Troitsa; Eran Brauner; Sebastiaan Van Cauwenberge; Marieke De Visschere; Bruno Dillemans Journal: Obes Surg Date: 2011-02 Impact factor: 4.129
Authors: Neil H Bhayani; Aditya Gupta; Ashwin A Kurian; Christy M Dunst; Ahmed H Sharata; Kevin M Reavis; Lee L Swanstrom; Valerie J Halpin Journal: Surg Endosc Date: 2012-05-31 Impact factor: 4.584
Authors: Markus Weber; Markus K Müller; Tanja Bucher; Stefan Wildi; Daniel Dindo; Fritz Horber; Rennward Hauser; Pierre-Alain Clavien Journal: Ann Surg Date: 2004-12 Impact factor: 12.969
Authors: Torgeir T Søvik; Erlend T Aasheim; Jon Kristinsson; Carl Fredrik Schou; Lien My Diep; Arild Nesbakken; Tom Mala Journal: Obes Surg Date: 2008-06-20 Impact factor: 4.129