Leveling the Learning Curve for Laparoscopic Bariatric Surgery

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2005 May 4

PMID 15868262

Citations 16

Authors

M Lublin

S Lyass

B Lahmann

S A Cunneen

T M Khalili

J D Elashoff

E H Phillips

Affiliations

Soon will be listed here.

Abstract

Background: The learning curve for laparoscopic bariatric surgery is associated with increased morbidity and mortality.

Methods: The study included the first 100 patients undergoing laparoscopic Roux-en-Y gastric bypass (LGB) by a designated surgical team. Surgeon A operated as primary surgeon, with surgeon B assisting (Stage 1). Surgeon B learned LGB in stages: exposure and jejunojejunostomy (stage 2), gastric pouch (stage 3), gastrojejunostomy (stage 4), and sequence all steps (stage 5).

Results: Surgeon A achieved confidence with LGB after 20 cases and surgeon B after 25 cases (stage 2), 18 cases (stage 3), 21 cases (stage 4), and 16 cases (stage 5). Complications (8%) included small bowel obstruction (three); pulmonary embolus (two), and leak, stomal stenosis, and gastrogastric fistula (one each). There was a decreasing trend for operative duration, length of stay, and complications across the five stages (p < 0.05).

Conclusions: By transferring skills in stages, a laparoscopic bariatric program can be established with minimal morbidity and mortality.

Citing Articles

The Utilization of Bloom's Taxonomy in Bariatric Surgery Training: A Comprehensive Approach to Mastery in Surgery.

Abokhozima A, El-Masry H, Hany M, Zidan M Obes Surg. 2025; 35(2):383-386.

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Laparoscopic management of a left hepatic vein injury during one -step laparoscopic Roux-en-Y gastric bypass after adjustable gastric banding removal: A case report.

Lawani I, Costantino F, Imorou Souaibou Y, Morelli U, Dossou F, Keller P Int J Surg Case Rep. 2022; 94:107043.

PMID: 35658274 PMC: 9093008. DOI: 10.1016/j.ijscr.2022.107043.

Multiple Complex Complications After Redo Bariatric Surgery (Infrequent Complication: Fistula Between the Splenic Artery and the Remnant of the Stomach): A Case Report.

Abdolhosseini M, Haj Mohamad Ebrahim Ketabforoush A, Parhizgar P, Tavallaei M Clin Med Insights Case Rep. 2022; 15:11795476221088494.

PMID: 35465626 PMC: 9021477. DOI: 10.1177/11795476221088494.

Learning Curves of Laparoscopic Roux-en-Y Gastric Bypass and Sleeve Gastrectomy in Bariatric Surgery: a Systematic Review and Introduction of a Standardization.

Wehrtmann F, de la Garza J, Kowalewski K, Schmidt M, Muller K, Tapking C Obes Surg. 2019; 30(2):640-656.

PMID: 31664653 DOI: 10.1007/s11695-019-04230-7.

Systematic review of operative outcomes of robotic surgical procedures performed with endoscopic linear staplers or robotic staplers.

Gutierrez M, Ditto R, Roy S J Robot Surg. 2018; 13(1):9-21.

PMID: 29744808 PMC: 6397135. DOI: 10.1007/s11701-018-0822-5.

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