Tomasz Stefura1, Mateusz Rubinkiewicz, MD2, Mateusz Wierdak, MD2, Jakub Dros1, Artur Kacprzyk1, Oksana Skomarovska1, Marta Krzysztofik1, Katarzyna Chlopas1, Michal Wysocki, MD2, Magdalena Pisarska, MD2, Piotr Malczak, MD2, Michal Pedziwiatr, MD, PhD2, Andrzej Budzynski, MD, PhD2, Piotr Major, MD, PhD2. 1Students’ Scientific Group at 2nd Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland, 22nd Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
Introduction: The most commonly performed bariatric procedures include laparoscopic sleeve gastrectomy (LSG), laparoscopic Roux-en-Y gastric bypass (LRYGB) and mini gastric bypass, also known as one anastomosis gastric bypass (MGB-OAGB). A study comparing the degree of difficulty of those procedures could serve as a guide for decision making in bariatric surgery. Moreover, it would help to further improve training programs and curriculums for general surgery trainees.
Materials and Methods: An anonymous internet-based survey was designed to evaluate subjective opinions of surgeons and surgical residents in training in Poland. It covered baseline characteristics of the participant, incidence of technical difficulties during bariatric operations in groups of patients based on the Body Mass Index (BMI), difficulty of LSG, MGB-OAGB, LRYGB and particular stages of each operation assessed on a scale 1-5.
Results: Overall, 70 surgeons and residents from 16 Polish surgical centers participated in our survey. Surgeons reported the highest incidence of technical difficulties during bariatric operation in patients with BMI above 60. The incidence of difficulties seems to correlate with increasing BMI. Mean difficulty degree of LSG was 2.34 ± 0.89. The reinforcing staple line with sutures was considered most difficult stage of this operation (3.17 ± 1.19). The LRYGB operation had an average difficulty level of 3.87 ± 1.04. Creation of the gastrojejunostomy was considered the most difficult stage of LRYGB with mean difficulty level (3.68 ± 1.16). Responders to our survey assessed mean degree of difficulty of MGB-OAGB’s as 2.34 ± 0.97. According to participating surgeons creating the gastrojejunostomy is the most difficult phase of this operation (3.68 ± 1.16).
Conclusion: The LSG is perceived by surgeons as relatively easy operation and good to start with. The LRYGB was considered to be the most technically challenging procedure among operations included in our survey. Operative stages, which require intra-abdominal suturing with laparoscopic instruments seem to be the most difficult phases of any operation.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94186
Program Number: P091
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster