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Obesity Surgery
Published in: Obesity Surgery 6/2023

29-04-2023 | Bariatric Surgery | Original Contributions

Five-Year Experience Training Surgeons with a Laparoscopic Simulation Training Program for Bariatric Surgery: a Quasi-experimental Design

Authors: Valentina Duran Espinoza, Francisca Belmar Riveros, Cristian Jarry Trujillo, Maria Ines Gaete Dañobeitia, Isabella Montero Jaras, Mariana Miguieles Schilling, Brandon Valencia Coronel, Gabriel Escalona, Pablo Achurra Tirado, Nicolas Quezada, Fernando Crovari, Julian Varas Cohen

Published in: Obesity Surgery | Issue 6/2023

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Abstract

Purpose

Nearly 200,000 laparoscopic Roux-en-Y gastric bypass (LRYGB) are performed yearly. Reported learning curves range between 50 and 150, even 500 cases to decrease the operative risk. Simulation programs could accelerate this learning curve safely; however, trainings for LRYGB are scarce. This study aims to describe and share our 5-year experience of a simulated program designed to achieve proficiency in LRYGB technical skills.

Materials and Methods

A quasi-experimental design was used. All recruited participants were previously trained with basic and advanced laparoscopic simulation curriculum completing over 50 h of practical training. Ex vivo animal models were used to practice manual and stapled gastrojejunostomy (GJ) and stapled jejunojejunostomy (JJO) in 10, 3, and 4 sessions, respectively. The main outcome was to assess the manual GJ skill acquisition. Pre- and post-training assessments using a Global Rating Scale (GRS; max 25 pts), Specific Rating Scale (SRS; max 20 pts), performance time, permeability, and leakage rates were analyzed. For the stapled GJ and JJO, execution time was registered. Data analysis was performed using parametric tests.

Results

In 5 years, 68 trainees completed the program. For the manual GJ’s pre- vs post-training assessment, GRS and SRS scores increased significantly (from 17 to 24 and from 13 to 19 points respectively, p-value < 0.001). Permeability rate increased while leakage rate and procedural time decreased significantly.

Conclusion

This simulated training program showed effectiveness in improving laparoscopic skills for manual GJ and JJO in a simulated scenario. This new training program could optimize the clinical learning curve. Further studies are needed to assess the transfer of skills to the operating room.

Graphical Abstract

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Metadata
Title
Five-Year Experience Training Surgeons with a Laparoscopic Simulation Training Program for Bariatric Surgery: a Quasi-experimental Design
Authors
Valentina Duran Espinoza
Francisca Belmar Riveros
Cristian Jarry Trujillo
Maria Ines Gaete Dañobeitia
Isabella Montero Jaras
Mariana Miguieles Schilling
Brandon Valencia Coronel
Gabriel Escalona
Pablo Achurra Tirado
Nicolas Quezada
Fernando Crovari
Julian Varas Cohen
Publication date
29-04-2023
Publisher
Springer US
Published in
Obesity Surgery / Issue 6/2023
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-023-06616-0

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