P Schauer1, S Ikramuddin, G Hamad, W Gourash. 1. Department of Surgery, The Minimally Invasive Surgery Center, University of Pittsburgh, Presbyterian University Hospital, C-800, 200 Lothrop Street, Pittsburgh, PA 15213-2582, USA. schauerpr@msx.upmc.edu
Abstract
BACKGROUND: The purpose of this study was to determine the effect of operative experience on perioperative outcomes for laparoscopic Roux-en-Y gastric bypass (LGB). METHODS: Between July 1997 and September 2001, 750 patients underwent LGB for the treatment of morbid obesity at our center. We evaluated the perioperative outcomes of the first 150 consecutive patients to determine if a learning curve effect could be demonstrated. The patients were divided into three groups (1, 2, and 3) of 50 consecutive patients, and outcomes for each group were compared. RESULTS: The patients in group 3 had a larger body mass index (BMI), were more likely to have had prior abdominal surgery, and were more likely to have secondary operations at the time of LGB. Operating time decreased from a mean of 311 min in group 11 to 237 min in group 3, and technical complications were reduced by 50% after an experience of 100 cases. CONCLUSIONS: Operative time and technically related complications decreased with operative experience even though heavier patients and higher-risk patients were more predominant in the latter part of our experience. LGB is a technically challenging operation with a long learning curve. To minimize morbidity related to the learning curve, strategies for developing training programs must address these challenges.
BACKGROUND: The purpose of this study was to determine the effect of operative experience on perioperative outcomes for laparoscopic Roux-en-Y gastric bypass (LGB). METHODS: Between July 1997 and September 2001, 750 patients underwent LGB for the treatment of morbid obesity at our center. We evaluated the perioperative outcomes of the first 150 consecutive patients to determine if a learning curve effect could be demonstrated. The patients were divided into three groups (1, 2, and 3) of 50 consecutive patients, and outcomes for each group were compared. RESULTS: The patients in group 3 had a larger body mass index (BMI), were more likely to have had prior abdominal surgery, and were more likely to have secondary operations at the time of LGB. Operating time decreased from a mean of 311 min in group 11 to 237 min in group 3, and technical complications were reduced by 50% after an experience of 100 cases. CONCLUSIONS: Operative time and technically related complications decreased with operative experience even though heavier patients and higher-risk patients were more predominant in the latter part of our experience. LGB is a technically challenging operation with a long learning curve. To minimize morbidity related to the learning curve, strategies for developing training programs must address these challenges.
Authors: A Z Fernandez; E J DeMaria; D S Tichansky; J M Kellum; L G Wolfe; J Meador; H J Sugerman Journal: Surg Endosc Date: 2003-12-29 Impact factor: 4.584
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