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Obesity Surgery

, Volume 29, Issue 1, pp 143–148 | Cite as

Laparoscopic Sleeve Gastrectomy Learning Curve: Clinical and Economical Impact

  • Sergio CarandinaEmail author
  • Laura Montana
  • Marc Danan
  • Viola Zulian
  • Marius Nedelcu
  • Christophe Barrat
Original Contributions
  • 114 Downloads

Abstract

Background

The results in the literature regarding the learning curve (LC) of laparoscopic sleeve gastrectomy (LSG) are scarce and non-definitive. The purpose of the study was to evaluate the correlation between the LSG learning curve and intraoperative parameter variation, postoperative morbidity, weight loss results, and economic impact.

Methods

The first 99 obese patients undergoing LSG surgery by the same surgeon from March 2013 to April 2016 were included in the present study. Patients were equally distributed among three groups (A, B, C) based on case sequence.

Results

The three study groups were homogeneous with respect to age, BMI, gender, and comorbidities. There was a significant reduction in operative time among the groups (p < 0.00001), with a difference of approximately 40 min between the first and third groups. The decrease in operative time was associated with a decrease in the number of stapler firings used per LSG. Conversely, there was no statistical correlation between intraoperative blood loss, intraoperative complications, or weight loss 1-year postsurgery and the LSG learning curve. In addition, the increase in experience with LSG was also associated with a significant reduction (p < 0.00001) in the length of hospital stay. With respect to postoperative complications, a statistically significant difference was recorded between groups B and C (p = 0.02). Finally, a patient undergoing surgery at the end of the LC had an estimated reduction in economic impact of approximately 2700 Euros compared with a patient undergoing surgery at the beginning of the LC.

Conclusion

Approximately 60 cases are required to reach proficiency in reducing postoperative complications and costs of LSG.

Keywords

Learning curve Laparoscopic sleeve gastrectomy Proficiency Staple firings Operative time Length of hospital stay 

Notes

Compliance with Ethical Standards

Conflict of Interests

The authors declare that they have no conflict of interest.

Statement of Informed Consent

For this type of study, formal consent is not required.

Statement of Human Rights

All of the procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional research committee and the 1964 Helsinki.

Financial or Material Support

None.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.ELSAN, Clinique Saint MichelCentre Chirurgical de l’Obesité (CCO)ToulonFrance
  2. 2.Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Digestive and Metabolic Surgery, Avicenne University Hospital, Centre Intégré Nord Francilien de la prise en charge de l’Obésité (CINFO)Université Paris XIII-UFR SMBH “Léonard de Vinci”BobignyFrance

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