Surgical Staff The included surgical staff were a postgraduate year (PGY) 2 resident with < 100 cases laparoscopic experience and less than 10 LRYGB cases, a PGY 6 resident (the Dutch Surgical training program has a 6-year curriculum) with 100 - 500 laparoscopic cases as first surgeon, but less than 100 LRYGB cases and finally an attending surgeon with over 1000 laparoscopic cases and > 500 LRYGB cases were selected (Table 3). Table 3: Characteristics of the (Resident) Surgeons Subject Exper2se Level PGY Laparoscopic cases LRYGB cases 1 Beginner 2 10 - 100 < 10 2 Intermediate 6 100 - 500 10 - 100 3 Expert Surgeon > 1000 > 500 LRYGB = laparoscopic Roux-en-Y gastric bypass, PGY = postgraduate year The Expert Assessor Panel The expert team consisted of three women and 9 males. All assessors had performed over 1000 laparoscopic cases. Two experts had performed 500-1000 metabolic bariatric cases, all others > 1000 cases. Ten experts had over 10 years of experience after training. Two attending surgeons had 5-10 years of clinical experience, both had > 1000 laparoscopic cases and > 500 LRYGB procedures. The Assessments The mean scores of the items in the substeps and standard deviation (SD) are shown in Table 4. In all assessments the overall scores increased with the level of experience. However, in the BPL and GJ step the intermediate surgeon gained higher mean scores than the expert (4.75 vs 4.00, P = 0.005). As this was not the case in the other steps (all p > 0.05), creation of the gastric pouch and AL and JJ, taking all steps together the three assessments could differentiate between the different expertise levels. However, for the BPL and GJ the BOSATS was not significant. The same was found in the creation of the gastric pouch in the PBA. Figure 1 shows the median scores, IQR and minimum and maximum scores on these assessments. 5 89 A new procedure-based assessment in gastric bypass surgery
RkJQdWJsaXNoZXIy MTk4NDMw