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Open Access 01-06-2018 | Original Contributions

Analysis of Laparoscopic Sleeve Gastrectomy Learning Curve and Its Influence on Procedure Safety and Perioperative Complications

Authors: Piotr Major, Michał Wysocki, Jadwiga Dworak, Michał Pędziwiatr, Magdalena Pisarska, Mateusz Wierdak, Anna Zub-Pokrowiecka, Michał Natkaniec, Piotr Małczak, Michał Nowakowski, Andrzej Budzyński

Published in: Obesity Surgery | Issue 6/2018

Abstract

Purpose

Laparoscopic sleeve gastrectomy (LSG) has become an attractive bariatric procedure with promising treatment effects yet amount of data regarding institutional learning process is limited.

Materials and Methods

Retrospective study included patients submitted to LSG at academic teaching hospital. Patients were divided into groups every 100 consecutive patients. LSG introduction was structured along with Enhanced Recovery after Surgery (ERAS) treatment protocol. Primary endpoint was determining the LSG learning curve’s stabilization point, using operative time, intraoperative difficulties, intraoperative adverse events (IAE), and number of stapler firings. Secondary endpoints: influence on perioperative complications and reoperations. Five hundred patients were included (330 females, median age of 40 (33–49) years).

Results

Operative time in G1–G2 differed significantly from G3–G5. Stabilization point was the 200th procedure using operative time. Intraoperative difficulties of G1 differed significantly from G2–G5, with stabilization after the 100th procedure. IAE and number of stapler firings could not be used as predictor. Based on perioperative morbidity, the learning curve was stabilized at the 100th procedure. The morbidity rates in the groups were G1, 13%; G2, 4%; G3, 5%; G4, 5%; and G5, 2%. The reoperation rate in G1 was 3%; G2, 2%; G3, 2%; G4, 1%; and G5, 0%.

Conclusion

The institutional learning process stabilization point for LSG in a newly established bariatric center is between the 100th and 200th operation. Initially, the morbidity rate is high, which should concern surgeons who are willing to perform bariatric surgery.

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Title: Analysis of Laparoscopic Sleeve Gastrectomy Learning Curve and Its Influence on Procedure Safety and Perioperative Complications
Authors: Piotr Major
Michał Wysocki
Jadwiga Dworak
Michał Pędziwiatr
Magdalena Pisarska
Mateusz Wierdak
Anna Zub-Pokrowiecka
Michał Natkaniec
Piotr Małczak
Michał Nowakowski
Andrzej Budzyński
Publication date: 01-06-2018
Publisher: Springer US
Published in: Obesity Surgery / Issue 6/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-017-3075-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Analysis of Laparoscopic Sleeve Gastrectomy Learning Curve and Its Influence on Procedure Safety and Perioperative Complications

Abstract

Purpose

Materials and Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Materials and Methods

Results

Conclusion

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