Table 2: Average Start of Postgraduate Training Gastric bypass Reported PGY Gastric sleeve Reported PGY Pre-opera2ve checklist Instrument check 1.5 (1-4) 1,5 (1-4) Team posiqon 1.5 (1-4) 2 (1-4) Monitor posiqon 2 (1-4) 2 (1-4) Paqent posiqon 2 (1-4) 2 (1-4) Anqbioqc prophylaxis check 1 (1-4) 2 (1-4) Disinfecqon/sterile field 1 (1-4) 2 (1-4) Inserqon gastric bougie 1.5 (1-4) 2 (1-4) Ini2alizing pneumoperitoneum Camera assisted trocar introducqon 2 (1-4) 2 (1-4) Introducqon Veress needle 2 (1-4) 2 (1-4) Introducqon trocars 2 (1-4) 2 (1-4) Diagnosqc laparoscopy 2 (1-4) 2 (1-4) Exposure opera2ng field Introducqon liver retractor 2.5 (1-5) 3 (1-5.5) Opening of pars flaccid 3 (1-4) - - Exposiqon of greater curvature - - 3 (2-6.5) Exposiqon of crus - - 3.5 (2-6.5) Stapling of stomach/sleeve 4 (2-.,5) 3.5 (2-6.5) Separaqon of greater omentum 3 (2-5.5) - - Measuring jejunum from Treitz 4 (2-6) - - Stapled gastrojejunostomy 4 (2-6) - - Placement stay sutures 4 (3-5.5) - - Suturing pouch defect 4 (2-6) - - Measuring jejunum pouch-distal 3.5 (2-6) - - Creaqon stapled jejunojejunostomy 4 (2-6) - - Placement stay sutures on jejunum 2 (2-5.5) - - Suture jejunal anastomoqc defect 4 (2-6) - - Transecqon of the bowel limb 4 (1-6) - - Closure mesenteric defect 3.5 (1-6) - - Extracqon gastric remnant - - 3.5 (2-6.5) Finishing procedure Removal gastric bougie 2 (1-4) 2 (0-4) Removal liver retractor 2.5 (1-4) 2 (1-4) Removal trocars 2 (1-4) 2 (1-4) Closing fascia defects > 10mm 2 (1-4) 2.5 (1-4) Skin suturing 1 (1-2) 1 (1-3) PGY = postgraduate year Reported average start of postgraduate training year for each step of laparoscopic gastric bypass and sleeve gastrectomy procedure as reported by lead metabolic bariatric surgeons Fellowship training is displayed as PGY 7 to 8 Data displayed as median (range) 3 49 Resident training in metabolic bariatric surgery in the Netherlands
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