Far from Standardized: Using Surgical Videos to Identify Variation in Technique for Laparoscopic Sleeve Gastrectomy
Published on Aug 1, 2017in Journal of Laparoendoscopic & Advanced Surgical Techniques1.322
· DOI :10.1089/lap.2017.0184
Abstract Background: Video assessment is an emerging tool for understanding variation in surgical technique. Methods: Representative videos of laparoscopic sleeve gastrectomy (LSG) were voluntarily submitted by 20 surgeons who participated in a statewide quality improvement collaborative. The amount of time required to complete the salient steps of the operation was measured and variations in the tasks performed during each step were captured. Results: Twenty-two videos of LSG were submitted and 11 videos included concurrent hiatal hernia repair. Data obtained from video analysis identified variation in time to complete each step of the procedure: prestapling dissection of stomach (5–25 minutes), gastric stapling (8–20 minutes), and management of the staple line (1–25 minutes). Time required to perform a hiatal hernia repair also varied (1–26 minutes), as did the type of repair: 55% were performed with a posterior cruropexy, 27% were performed with an anterior cruropexy, and 18% were performed with both. ...