BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is a relatively new bariatric procedure, and data regarding the learning curve are scarce. The aim of this study is to assess how the procedure can be safely implanted in a newly established bariatric unit and to define the learning curve. METHODS: Proctorship and mentorship in bariatric surgery were attended by two surgeons who were previously experienced in advanced laparoscopic surgery. The first consecutive 102 patients who underwent LSG in our newly established bariatric center were included. Patients were divided into three groups of 34 (groups 1, 2, and 3) according to case sequence. Data on demographics, operative time, conversion rate, hospital stay, morbidity, mortality, and excess weight loss (EWL) over time were compared between the groups. RESULTS: The operative time was significantly lower in groups 2 (p = 0.016) and 3 (p = 0.003) compared to group 1. The learning curve was flat up to the 68th case. A significant decrease in hospital stay was noted for group 3 compared to groups 1 (p < 0.001) and 2 (p = 0.002). The conversion rate, mortality and morbidity rates, and EWL did not differ significantly between the groups. Mortality was 0.98% and procedure-related morbidity was 7.8%. CONCLUSIONS: LSG can be safely and efficiently performed in a newly established bariatric center following a mentorship procedure. Proficiency seems to require 68 cases. The operative time and hospital stay may significantly decrease with experience early in the learning curve, as opposed to mortality and morbidity rates, conversion rate, and EWL.
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is a relatively new bariatric procedure, and data regarding the learning curve are scarce. The aim of this study is to assess how the procedure can be safely implanted in a newly established bariatric unit and to define the learning curve. METHODS: Proctorship and mentorship in bariatric surgery were attended by two surgeons who were previously experienced in advanced laparoscopic surgery. The first consecutive 102 patients who underwent LSG in our newly established bariatric center were included. Patients were divided into three groups of 34 (groups 1, 2, and 3) according to case sequence. Data on demographics, operative time, conversion rate, hospital stay, morbidity, mortality, and excess weight loss (EWL) over time were compared between the groups. RESULTS: The operative time was significantly lower in groups 2 (p = 0.016) and 3 (p = 0.003) compared to group 1. The learning curve was flat up to the 68th case. A significant decrease in hospital stay was noted for group 3 compared to groups 1 (p < 0.001) and 2 (p = 0.002). The conversion rate, mortality and morbidity rates, and EWL did not differ significantly between the groups. Mortality was 0.98% and procedure-related morbidity was 7.8%. CONCLUSIONS: LSG can be safely and efficiently performed in a newly established bariatric center following a mentorship procedure. Proficiency seems to require 68 cases. The operative time and hospital stay may significantly decrease with experience early in the learning curve, as opposed to mortality and morbidity rates, conversion rate, and EWL.
Authors: G Casella; E Soricelli; M Rizzello; P Trentino; F Fiocca; A Fantini; F M Salvatori; N Basso Journal: Obes Surg Date: 2009-04-21 Impact factor: 4.129
Authors: John J Kelly; Scott Shikora; Daniel B Jones; Matthew H Hutter; Malcolm K Robinson; John Romanelli; Frederick Buckley; Andrew Lederman; George L Blackburn; David Lautz Journal: Obesity (Silver Spring) Date: 2009-02-19 Impact factor: 5.002
Authors: Raquel Sánchez-Santos; Carlos Masdevall; Aniceto Baltasar; Candido Martínez-Blázquez; Amador García Ruiz de Gordejuela; Enric Ponsi; Andres Sánchez-Pernaute; Gregorio Vesperinas; Daniel Del Castillo; Ernest Bombuy; Carlos Durán-Escribano; Luis Ortega; Juan Carlos Ruiz de Adana; Javier Baltar; Ignacio Maruri; Emilio García-Blázquez; Antonio Torres Journal: Obes Surg Date: 2009-07-02 Impact factor: 4.129