Evidence map›Paper›PMID 28936562›Full record

ArticleSurgical endoscopy2018

Can a laparoscopic Roux-en-Y gastric bypass be safely performed by surgical residents in a bariatric center-of-excellence? The learning curve of surgical residents in bariatric surgery.

Anne-Sophie van Rijswijk, Daan E Moes, Noëlle Geubbels, Barbara A Hutten, Yair I Z Acherman, Arnold W van de Laar, Maurits de Brauw, Sjoerd C Bruin

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Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Anne-Sophie van RijswijkDepartment of Metabolic and Bariatric Surgery, Medical Center Slotervaart, Louwesweg 6, PO box 90440, 1006 BK, Amsterdam, The Netherlands. anne-sophie.vanrijswijk@slz.nl.ORCID http://orcid.org/0000-0002-8086-3265
Daan E MoesDepartment of Metabolic and Bariatric Surgery, Medical Center Slotervaart, Louwesweg 6, PO box 90440, 1006 BK, Amsterdam, The Netherlands.
Noëlle GeubbelsDepartment of Metabolic and Bariatric Surgery, Medical Center Slotervaart, Louwesweg 6, PO box 90440, 1006 BK, Amsterdam, The Netherlands.
Barbara A HuttenDepartment of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands.
Yair I Z AchermanDepartment of Metabolic and Bariatric Surgery, Medical Center Slotervaart, Louwesweg 6, PO box 90440, 1006 BK, Amsterdam, The Netherlands.
Arnold W van de LaarDepartment of Metabolic and Bariatric Surgery, Medical Center Slotervaart, Louwesweg 6, PO box 90440, 1006 BK, Amsterdam, The Netherlands.
Maurits de BrauwDepartment of Metabolic and Bariatric Surgery, Medical Center Slotervaart, Louwesweg 6, PO box 90440, 1006 BK, Amsterdam, The Netherlands.
Sjoerd C BruinDepartment of Metabolic and Bariatric Surgery, Medical Center Slotervaart, Louwesweg 6, PO box 90440, 1006 BK, Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA learning curve (LC) is a graphic display of the number of consecutive procedures performed necessary to reach competence and is defined by complications and duration of surgery (DOS). There is little evidence on the LC of surgical residents in bariatric surgery. Aim of the study is to evaluate whether the laparoscopic Roux-en-Y gastric bypass (LRYGB) can be safely performed by surgical residents, to evaluate the LC of surgical residents for LRYGB and to assess whether surgical residents fit in the LC of the bariatric center which has been established by their proctors.

methodsRecords of all 3389 consecutive primary LRYGB patients, operated between December 2007 and January 2016 in a bariatric center-of-excellence in Amsterdam, were reviewed. Differences in DOS were assessed by means of a linear regression model. Differences in complications (classified as Clavien-Dindo ≥ 2) were evaluated with the χ

resultsFour surgeons (S1-4) and three residents (R1-3) performed 2690 (88.2%) and 361 (11.8%) of 3051 LRYGBs, respectively. Median (IQR) DOS was 52.0 (42.0-65.0) min for S1-4 versus 53.0 (46.0-63.0) min for R1-3 (p = 0.52). The LC of R1-3 in their first 70 cases (n = 210) differs significantly from the individual (n = 70) LCs of surgeon 1, 2, and 3, with remarkably shorter DOS for the residents (adjusted p < 0.0001; p < 0.001 and p = 0.0002, respectively) and the same amount of surgical complications 5.1% (137/2690) for S1-4 versus 3.0% (11/361) for R1-3 (p = 0.089).

conclusionLaparoscopic Roux-en-Y gastric bypass can be safely performed by surgical residents under supervision of experienced bariatric surgeons. Surgical residents benefit from the experience of their proctors and they fit faultlessly in the LC of the surgical team, as set out by their proctors in a large bariatric center-of-excellence.

Indexed as

Internship and ResidencyLearning CurveAdultFemaleGastric BypassHumansLaparoscopyMaleMiddle AgedNetherlandsObesity, MorbidPostoperative ComplicationsRetrospective StudiesTime FactorsTreatment OutcomeBariatric surgeryCenter-of-excellenceLearning curveRoux-en-Y gastric bypassSurgical residents

Identifiers

PMID28936562

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.