Postoperative Complications Clinical Trial
Official title:
Structured Bariatric Fellowship Programme Moelholm Private Hospital - Denmark. Learning Laparoscopic RY - Gastric Bypass One Way to do it
Background: Laparoscopic Roux en Y gastric bypass (LRYGB) is associated with a significant
learning curve. We report the results of a systematic training programme from a high volume
bariatric center measuring the outcome by comparing the results with data from a consecutive
series of 1000 fast track LRYGB.
Method: Using a stepwise training programme the RY gastric bypass operation was divided into
an upper and lower procedure and subdivided into 11 well defined steps. A laparoscopic
surgeon without experience in upper GI surgery was mentored by an experienced bariatric
surgeon. During 6 months full time fellowship 300 operations were performed.
Results: The trainee surgeon performed 61 upper procedures, and 121 lower procedures in
which the mentor surgeon did the other part of the operation. In 110 patients the trainee
performed both procedures. Two percent had peri-operative complications compared to 1% of
1000 patients. All were repaired and had an uneventful recovery. Two percent had
postoperative complications < 30 days compared to 2.8% in the clinic. In the trainees series
there were no leaks compared to 1% in 1000 patients. Operative time was 56/55/70 min for
operation 0-100/100-200/200-300 compared with an average of 47 minutes registered in the
clinic. Concerning time to discharge there was no difference between patients operated by
the trainee and the standard of the clinic.
Conclusion: Using a systematic training program in laparoscopic RY gastric bypass surgery
eliminates morbidity of the learning curve without affecting the volume.
n/a
Observational Model: Cohort, Time Perspective: Prospective
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