title: [Learning curve in laparoscopic Roux-en-Y gastric bypass for the treatment of morbid obesity].
abstract: BACKGROUND
  Laparoscopic Roux-en-Y gastric bypass (LRYGB) is currently considered the gold standard treatment for morbid obesity. The learning curve for this procedure is about 100 cases, and it is considered the most important factor in decreasing complications and mortality. We present our experience and learning curve with LRYGB.
  
  
  METHODS
  The data was collected prospectively. All patients with primary LRYGB between March 2006 and April 2014 were included. Only patients with full data on demographics, length of stay, operating time, and complications were included in the study.
  
  
  RESULTS
  Five hundred and eleven patients underwent a LRYGB. Ninety five of them underwent a redo RYGB (conversion), and were excluded. Of the remaining 416 patients, full data was available for 326 and the statistical analysis refers to this group. The complication rate was available for all patients who were included in the study. The mean age and body mass index were 43 years (14-76 years) and 42.8 kg/m2 (34-76) respectively. The mean duration of surgery was 86 minutes (40-420). In the first 100 patients, operating time was 148 min, while in the last 125 patients it was 75 min. The major perioperative complication rate was 7.7%. Of 4 leaks (0.95%, 3 were encountered in the first 100 operations, and one in the following 316 (3% and 0.3% respectively). The mean length of stay was 2.2 days (1-46). None of the patients stayed in the intensive care unit. There was no mortality.
  
  
  CONCLUSIONS
  LRYGB is very safe. We confirm that the learning curve for this procedure is more than 100 cases. Appropriate training is crucial.
authors.forename: Matan
authors.initials: M
authors.lastname: Ben David
authors.forename: Ilanit
authors.initials: I
authors.lastname: Maler
authors.forename: Hanoch
authors.initials: H
authors.lastname: Kashtan
authors.forename: Andrei
authors.initials: A
authors.lastname: Keidar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects / Q000193:education / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000193:education / Q000379:methods*; D059032:Learning Curve; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult