The Learning Curve Measured by Operating Times for Laparoscopic and Open Gastric Bypass: Roles of Surgeon's Experience, Institutional Experience, Body Mass Index and Fellowship Training

Abstract

The length of surgery for LRYGBPs continued to shorten beyond 400 operations for the first surgeon performing LRYGBP in our hospital. Previous fellowship training in LRYGBP shortened surgical times during initial clinical experience as an attending for the second surgeon. The learning curve was truncated because of the already established LRYGBP program.

Advanced laparoscopic skills decrease the learning curve for laparoscopic Roux-en-Y gastric bypass

“…Several authors have shown that a surgeonÕs previous experience with advanced laparoscopic techniques and/or fellowship training shorten the learning curve with respect to both morbidity and operating time [1,9,12,18]. Our results strongly support these findings.…”

“…The American Society of Bariatric Surgeons (ASBS) and the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) have recommended guidelines for initiating a bariatric surgery program that will employ LRYGB, and several authors have published data with conclusions on the extent of experience required to establish a safe and effective surgical weight loss program [1,4,5,17]. Some authors have suggested that the learning curve is shorter for surgeons with prior development of advanced laparoscopic skills [9,18].…”

Impact of surgeon experience and buttress material on postoperative complications after laparoscopic sleeve gastrectomy

“…The learning curve was shorter for surgeons who initiated their experience at an institution with an established laparoscopic bariatric program [29,30]. On the basis of our data, this is also true for LSG, given that patient selection criteria, equipment and instruments, operative technique, postoperative care, and staff education are standardized and established.…”

Does establishing a bariatric surgery fellowship training program influence operative outcomes?

“…According to Kothari et al [9], fellowships in advanced laparoscopy with an emphasis on LRYGB provide the optimal training environment for the acquisition of skills necessary to perform bariatric operations safely and effectively. Moreover, fellowship training in LRYGB substantially shortens operative times during a surgeonÕs initial clinical experience in a hospital with an established bariatric surgery program [1].…”