A two-consultant approach is a safe and efficient strategy to adopt during the learning curve for laparoscopic Roux-en-Y gastric bypass: our results in the first 100 procedures
Abu-Hilal, M., Vanden Bossche, M., Bailey, I.S., Harb, A., Sutherland, R., Sansome, A.J. and Byrne, J.P. (2007) A two-consultant approach is a safe and efficient strategy to adopt during the learning curve for laparoscopic Roux-en-Y gastric bypass: our results in the first 100 procedures. Obesity surgery, 17, (6), 742-746. (doi:10.1007/s11695-007-9137-8). (PMID:17879572).
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Description/Abstract
Background: Laparoscopic Roux-en-Y gastric bypass (LRYGBP) can be technically challenging. It is imperative that patient morbidity and mortality are minimized while teams are on the learning curve for this procedure.
Methods: This retrospective study evaluated the peri-operative risk of LRYGBP utilizing a two-consultant surgeon approach in a newly established bariatric service. 100 consecutive patients undergoing LRYGBP were included. Two consultants participated in each procedure.
Results: Median operative duration was 113 minutes (range 80–240) and fell with increasing experience [127 minutes (range 90–240) in cases 1–50 and 105 minutes (range 80–210) in cases 51–100; P = 0.009]. Multivariate analysis found operation time correlated only with number of procedures performed (P < 0.001). There were no conversions to laparotomy. Intra-operatively, 2 patients had hand-assisted completion of the jejuno-jejunostomy, and 2 underwent laparoscopic revision of the reconstruction. Postoperative complications were observed in 8 patients on the operative admission. Median stay was 4 days (range 3–7). 4 patients required readmission. There was no mortality. Percentage of excess BMI loss was 47%, 53% and 70% at 3, 6 and 12 months respectively.
Conclusion: A learning curve for LRYGBP is evidenced in this series by reduction in operative time with increasing experience. Complication rates in line with large published series can be achieved by adopting a two-surgeon approach, which we propose as a safe method to adopt in the development of new bariatric services.
| Item Type: | Article |
|---|---|
| ISSNs: | 0960-8923 (print) 1708-0428 (electronic) |
| Keywords: | laparoscopic, roux-en-y, morbid obesity, gastric bypass, bariatric, learning curve |
| Subjects: | R Medicine > RB Pathology R Medicine > RD Surgery R Medicine > RF Otorhinolaryngology |
| Divisions: | University Structure - Pre August 2011 > School of Medicine |
| Item ID: | 172537 |
| Date Deposited: | 27 Jan 2011 09:34 |
| Last Modified: | 01 Jun 2011 10:25 |
| Contributors: | Abu-Hilal, M. (Author) Vanden Bossche, M. (Author) Bailey, I.S. (Author) Harb, A. (Author) Sutherland, R. (Author) Sansome, A.J. (Author) Byrne, J.P. (Author) |
| Date: | June 2007 |
| Status: | Published |
| URI: | http://eprints.soton.ac.uk/id/eprint/172537 |
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