size was sufficient to show significant differences. Additionally, the actual clinical consequences of inaccurate bowel length measurements on the outcomes after gastric bypass have not been investigated. However, a comparison of the findings of this study with existing literature has revealed that small bowel length deviations range from 21 to 36%. Intended limb lengths of 150 or 180 cm can result in a final length that exceeds 200 cm. This might have clinical implications as studies have shown limb lengths of more than 200 cm are associated with a higher incidence of nutritional deficiencies.26 CONCLUSION This study shows that with sufficient training using an ex vivo model with a box trainer, surgical residents improved their skill of laparoscopic small bowel length measurement. Moreover, 70% of residents feel their skills have improved by practicing this specific task, which is a key step in gastric bypass procedures. With high demands on operative quality and costs, this ex vivo training experiment is a relevant alternative and addition to on-site training. Note This chapter was updated to adhere to the 2024 IFSO Accepted Definitions for Publication and to enhance uniformity throughout this thesis. This research was originally published as: Kaijser MA, Slagter N, de Heide LJM, van Beek AP, Pierie JEN, Emous M. Measuring Small Bowel Length in Bariatric Surgery: An Ex Vivo Laparoscopic Training Experiment. Surg Innov. Published online April 16, 2024. 142 7
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