Authors: Noëlle Geubbels L Maurits de Brauw Yair I Z Acherman Arnold W J M van de Laar Michel W J M Wouters Sjoerd C Bruin
Publish Date: 2014/12/16
Volume: 25, Issue: 8, Pages: 1417-1424
Abstract
The learning curve of laparoscopic RouxenY gastric bypass LRYGB surgery has been well investigated The learning curve is defined by complications and/or by duration of surgery DOS Previous studies report an inverse relationship between patient outcome and patient volume In this study we investigate whether the learning curve of preceding bariatric surgeons is of additional influence for surgeons who start to perform LRYGB in the same centreWe retrospectively analysed the records of all 713 consecutive primary LRYGB patients operated in our centre from December 2007 until July 2012 Surgeon 1 and 3 had previous laparoscopic bariatric experience whilst Surgeon 2 and 4 had not We stratified the data between the four surgeons with different levels of experience and in a chronology of 50 casesSixtyseven 94 complications occurred in the study period Surgeon 1 had more complications occurring within the first 50 cases than Surgeon 4 10 versus 1 p 005 There was no difference in complication rate between groups of 50 consecutive cases None of the patients died DOS decreased for every consecutive surgeon irrespective of their experience The learning curve defined by DOS was steepest for Surgeon 1 followed by Surgeon 2 3 and 4In this study we show that the learning curve of the preceding surgeon positively influences the learning curve of latter surgeons irrespective of their experience Therefore the ‘preceding surgeon factor’ should be taken in account in addition to volume requirements when starting new bariatric facilities
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