Publication: Learning Curve for Laparoscopic Sleeve Gastrectomy: a Cumulative Summation (CUSUM) Analysis
Authors
Gil, Pedro J ; Ruíz‑Manzanera, Juan José ; Ruíz de Antgulo, David ; Munitiz, Vicente ; Ferreras, David ; López, Victor ; Conesa, ANA ; Ortiz, Angeles ; Martínez de Haro, Luisa Fernanda ; Ramírez, Pablo
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Publisher
Springer
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Description
© The Authors 2022.
This document is the published version of a published work that appeared in final form in Obesity Surgery.
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To access the final edited and published work see: https://doi.org/10.1007/s11695-022-06145-2
Abstract
Abstract
Purpose Bariatric surgery is currently considered the most effective and durable treatment option for morbid obesity. Laparoscopic
sleeve gastrectomy (LSG) has become a popular technique and may currently be the most frequently practiced
surgical operation to treat obesity. However, no objective analyses of its learning curve have been reported. Objective: to
analyze the learning curve for LSG.
Materials and Methods We included all LSGs performed in our hospital (University Hospital, Spain; Public Practice) from
April 2013 to February 2016. The learning curve for LSG was evaluated using cumulative sum (CUSUM) analysis. All
variables among the learning curve phases were compared.
Results According to the CUSUM analysis, the learning curve was divided into three unique phases: early learning (the initial
26 patients), acquisition of skills (the middle 30 patients), and mastery of technique (the final 56 patients). The operative
time and gastric stenosis significantly decreased with progression of the learning curve without differences in the 30-day
postoperative complication rate, postoperative stay, or weight loss.
Conclusion According to this study, the learning curve for LSG can be divided into 3 distinct phases, and about 25 patients
are needed to demonstrate an improvement in surgical skill.
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