Amador García Ruiz de Gordejuela1, Almino Cardoso Ramos2, Manoel Galvao Neto2, Mario Nora3, Antonio J Torres García4, Andrés Sánchez Pernaute4, Jordi Pujol Gebelli5. 1. Servei de Cirurgia General i de l'Aparell Digestiu, Hospital Universitari de Bellvitge, Barcelona, Spain. Electronic address: gordeju@icloud.com. 2. Gastro Obeso Center, Sao Paulo, Brazil. 3. Cirurgia Geral, Centre Hospitalar entre o Douro e Vouga, Santa Maria de Feira, Portugal. 4. Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico San Carlos, Madrid, Spain. 5. Servei de Cirurgia General i de l'Aparell Digestiu, Hospital Universitari de Bellvitge, Barcelona, Spain.
Abstract
INTRODUCTION: Live surgery is a topic of interest at every meeting or course in the field of surgery. The potential of laparoscopy for live broadcasting makes it an excellent tool in continuing medical education. Surgeons who participate in live surgeries are usually experienced, but several conditions may influence the results and safety of a procedure. OBJECTIVES: To analyze safety and outcomes in a series of patients who underwent surgery in the last 10 years in a live surgery course at our institution. SETTING: University public hospital in Spain. METHODS: Retrospective review of patients who underwent surgery during these courses from 2006 to 2016. Morbidity, mortality, and long-term results were analyzed. RESULTS: Of 107 patients, 74 (68.5%) were women, and 38 (35.2%) had revision surgery. Five had surgery during previous editions. The most performed procedures were Roux-en-Y gastric bypass (38.9%), sleeve gastrectomy (16.7%), and duodenal switch (14%). Ten cases were endoscopic procedures. Morbidity was 13% (14 cases), and 6 required early postoperative revision (5.6%). Most of the complications were Clavien types III and I. Bleeding was the most common (72.4%). There was no anastomotic leak, but 1 duodenal stump leak occurred. During follow-up, 6 patients had a surgical complication and 5 required revision surgery. There was no mortality. DISCUSSION: We found higher morbidity and reoperation rates. The conversion rate in long-term follow-up was higher. Despite the educational benefits, we should take into consideration the higher risk to our patients for future editions.
INTRODUCTION: Live surgery is a topic of interest at every meeting or course in the field of surgery. The potential of laparoscopy for live broadcasting makes it an excellent tool in continuing medical education. Surgeons who participate in live surgeries are usually experienced, but several conditions may influence the results and safety of a procedure. OBJECTIVES: To analyze safety and outcomes in a series of patients who underwent surgery in the last 10 years in a live surgery course at our institution. SETTING: University public hospital in Spain. METHODS: Retrospective review of patients who underwent surgery during these courses from 2006 to 2016. Morbidity, mortality, and long-term results were analyzed. RESULTS: Of 107 patients, 74 (68.5%) were women, and 38 (35.2%) had revision surgery. Five had surgery during previous editions. The most performed procedures were Roux-en-Y gastric bypass (38.9%), sleeve gastrectomy (16.7%), and duodenal switch (14%). Ten cases were endoscopic procedures. Morbidity was 13% (14 cases), and 6 required early postoperative revision (5.6%). Most of the complications were Clavien types III and I. Bleeding was the most common (72.4%). There was no anastomotic leak, but 1 duodenal stump leak occurred. During follow-up, 6 patients had a surgical complication and 5 required revision surgery. There was no mortality. DISCUSSION: We found higher morbidity and reoperation rates. The conversion rate in long-term follow-up was higher. Despite the educational benefits, we should take into consideration the higher risk to our patients for future editions.
Authors: Mina Awad; Manish Chowdhary; Shady Hermena; Sara El Falaha; Naim Slim; Nader K Francis Journal: Surg Endosc Date: 2022-05-23 Impact factor: 3.453