Table 3: Effects on Patient Outcomes and Costs Study OR 2me Early complica2ons Late complica2ons Surgical outcome Costs Davis et al.5 Increased 107 to 142 min Increased morbidity 4 to 5.2%. Increased return to OR 2.6 to 2.7% No differences - - Fanous et al.6 Increased 128 to 168 min No difference Increased acute renal failure 0 to 0.82% Nonsignificant 66 vs 64% EWL - Harrington et al.25 Increased 50 to 93.5 mina - - - $1457 per anastomosis Iordens et al.23 Increased 116 to 129 min No difference - - - Marqn et al.28 Decreased 209 to 116 min Decreased 15 to 5% Decreased strictures 10% to 3.6% - - Rovito et al.24 Decreased 213 to 170 min No differences No differences - - Varas et al.20 Increased 12 to 18.543.5 mina N/A N/A N/A - EWL = excess weight loss, OR = operating room, N/A = Not applicable a Study aimed to single step In Vivo Training Interventions Four studies described in vivo training interventions: a coaching program, a preoperative warm-up, and stepwise education.23,24,26,27 Bonrath et al. performed an RCT on the effect of surgical coaching.26 Their study focuses on the creation of the jejunojejunostomy as part of a laparoscopic RYGB. The study group of 18 participants was randomized between standard intraoperative coaching and standard coaching combined with “comprehensive surgical coaching,” i.e., extra operative video playback with self-reflection and feedback from a trained surgeon. This led to significant improvements in post training Bariatric Objective Structured Assessment of Technical Skill (BOSATS) scores (3.60 in control group vs. 3.90 in the intervention group, P = 0.017) and reduction of technical errors (18 in control group vs. 10 in 32 2
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