• Skip to main content
  • Skip to header right navigation
  • Skip to site footer

Log in
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
www.sages.org

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Awards
    • Who Is SAGES?
    • Leadership
    • Our Mission
    • Advocacy
    • Committees
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Committee Rosters
      • SAGES Past Presidents
  • Meetings
    • SAGES NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call for Abstracts
      • 2026 Emerging Technology Call for Abstracts
    • CME Claim Form
    • SAGES Past, Present, Future, and Related Meeting Information
    • SAGES Related Meetings & Events Calendar
  • Join SAGES!
    • Membership Application
    • Membership Benefits
    • Membership Types
      • Requirements and Applications for Active Membership in SAGES
      • Requirements and Applications for Affiliate Membership in SAGES
      • Requirements and Applications for Associate Active Membership in SAGES
      • Requirements and Applications for Candidate Membership in SAGES
      • Requirements and Applications for International Membership in SAGES
      • Requirements for Medical Student Membership
    • Member Spotlight
    • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Patient Information Brochures
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find A SAGES Surgeon
  • Publications
    • Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • Patient Information Brochures
    • Patient Information From SAGES
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • MesSAGES – The SAGES Newsletter
    • COVID-19 Archive
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • Avoid Opiates After Surgery
    • SAGES Subscription Catalog
    • SAGES TV: Home of SAGES Surgical Videos
    • The SAGES Safe Cholecystectomy Program
    • Masters Program
    • Resident and Fellow Opportunities
      • MIS Fellows Course
      • SAGES Robotics Residents and Fellows Courses
      • SAGES Free Resident Webinar Series
      • Fluorescence-Guided Surgery Course for Fellows
      • Fellows’ Career Development Course
    • SAGES S.M.A.R.T. Enhanced Recovery Program
    • SAGES @ Cine-Med Products
      • SAGES Top 21 Minimally Invasive Procedures Every Practicing Surgeon Should Know
      • SAGES Pearls Step-by-Step
      • SAGES Flexible Endoscopy 101
    • SAGES OR SAFETY Video Activity
  • Opportunities
    • Fellowship Recognition Opportunities
    • SAGES Advanced Flexible Endoscopy Area of Concentrated Training (ACT) SEAL
    • Multi-Society Foregut Fellowship Certification
    • Research Opportunities
    • FLS
    • FES
    • FUSE
    • Jobs Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • OWLS/FLS
You are here: Home / Abstracts / Defining the Learning Curve: Early Experience of Laparoscopic Roux-En-Y Gastric Bypass from a Bariatric Centre of Excellence

Defining the Learning Curve: Early Experience of Laparoscopic Roux-En-Y Gastric Bypass from a Bariatric Centre of Excellence

Andrew Smith, Ahmad Elnahas, Timothy Jackson, Fayez Quereshy, Todd Penner, David Urbach, Allan Okrainec. Division of General Surgery, University Health Network, University of Toronto, Toronto, ON.

INTRODUCTION

Obesity is a leading public health challenge. The laparoscopic Roux-en-Y gastric bypass (LRYGB) has emerged as an effective and durable treatment option. There is a learning curve associated with this advanced laparoscopic procedure. Previous studies indicate that this learning curve is within the range of 100 cases per surgeon. The aim of the current study is to describe the learning curve of LRYGB at a Bariatric Centre of Excellence by examining operative time and outcomes of three non-bariatric fellowship-trained advanced laparoscopic surgeons.

METHODS AND PROCEDURES

This retrospective cohort study employed a hospital-generated database that captured both elective and emergent bariatric procedures performed from November 16, 2009 to August 30th, 2013 at a single Ontario Bariatric Centre of Excellence. Patients who underwent an elective LRYGB by three non-bariatric fellowship-trained advanced laparoscopic surgeons were included in the study. Outcomes of interest included operative time and unexpected return to the operating room as captured in the database.

RESULTS

From November 16th, 2009 to August 30th, 2013, 734 elective LRYGB were performed. The first 100 cases per surgeon were analyzed and compared to subsequent cases. Mean operative time for the three surgeons decreased by over 15 minutes as experience with LRYGB increased (146 minutes versus 130.9 minutes; p<0.001). Unexpected return to the operating room decreased following the initial 100 cases, however this did not reach significance (4% unexpected return versus 2.08%; p<0.13). To further describe the institutional learning curve, the first 150 cases performed at our centre were analyzed and compared to the subsequent 584 cases performed. As an institution, the mean operative time decreased by over 20 minutes as experience with LRYGB increased (153.5 minutes versus 132.9 minutes; p<0.001). Similarly, unexpected return to the operating room decreased following the first 150 cases (5.33% unexpected return versus 2.23%; p<0.04).

CONCLUSION

LRYGB is a technically demanding procedure with an appreciable learning curve. Results from this single-centre retrospective cohort study demonstrate that as experience with this advanced laparoscopic procedure increases, operative time amongst surgeons, as well as within the institution, decreases. While the unexpected return to the operating room of this Bariatric Centre of Excellence decreased following the initial 150 cases, this small cohort study would suggest that there is a trend to decreased return to the operating room amongst individual surgeons following the initial 100 cases. Additional studies are required to further elucidate this learning curve both amongst individual surgeons as well as at the level of the institution itself.
 

View Poster

184

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon
  • Click to share on Threads (Opens in new window) Threads
  • Click to share on Bluesky (Opens in new window) Bluesky

Related


sages_adbutler_leaderboard

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064

1-310-437-0544

[email protected]

Monday – Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Bluesky
  • X
  • Instagram
  • Facebook
  • YouTube

Copyright © 2025 · SAGES · All Rights Reserved

Important Links

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals