Preceptorship and proctorship as an effective way to learn laparoscopic sleeve gastrectomy

Laparoscopic sleeve gastrectomy has rapidly gained popularity as a procedure for morbidly obese patients. The goal of this project is to evaluate a training program for the laparoscopic sleeve gastrectomy (LSG), given to a group of surgeons by a specialized consultant in bariatric surgery.

The training process is divided in two parts. First, bringing the trainee surgeons to a specialized bariatric center to observe and take part in bariatric procedures with an experienced bariatric surgeon (preceptorship). Second, the consulting surgeon offers on-site training to all surgeons within their own hospital (proctorship). The support personnel (bariatric nurse, OR nurse, nutritionist) accompany the surgeon and are included in the training process. Finally, preoperative, intraoperative and postoperative data are compiled and analyzed.

This study included 31 patients operated for LSG by the two newly trained surgeons after proctorship. Median age was 43 and mean BMI was 45.9. No leak, stricture, or mortality was found after the surgery. Mean surgical time was 94 min, and mean hospital length of stay was 3.9 days. Minor complications were seen during the follow-up at 1 to 3-6 months with excessive weight loss (EWL) of 62 % at 6 month.

This study showed the effectiveness of training provided through preceptorship/proctorship with a specialized consulting surgeon. The low complication rate and the weight loss achieved in only 6 months demonstrate the safety and efficacy of this learning method.