Analyzing the impact of surgical technique on intraoperative adverse events in laparoscopic Roux-en-Y gastric bypass surgery by video-based assessment

被引：0

作者：

Lavanchy, Joel L. ^{[1
,2
]}

Alapatt, Deepak ^{[3
,4
]}

Sestini, Luca ^{[4
,5
]}

Kraljevic, Marko ^{[1
]}

Nett, Philipp C. ^{[6
]}

Mutter, Didier ^{[3
,7
]}

Muller-Stich, Beat P. ^{[1
,2
]}

Padoy, Nicolas ^{[3
,4
]}

机构：

[1] Univ Digest Hlth Care Ctr Clarunis, POB 4002, Basel, Switzerland

[2] Univ Basel, Dept Biomed Engn, Allschwil, Switzerland

[3] IHU Strasbourg, Strasbourg, France

[4] Univ Strasbourg, CNRS, INSERM, ICube,UMR7357, Strasbourg, France

[5] Politecn Milan, Milan, Italy

[6] Univ Bern, Bern Univ Hosp, Inselspital, Dept Visceral Surg & Med, Bern, Switzerland

[7] Univ Hosp Strasbourg, Strasbourg, France

来源：

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 2025年 / 39卷 / 03期

关键词：

Intraoperative adverse events; Postoperative complications; Surgical phases; Surgical steps; Workflow analysis; Surgical data science; MESENTERIC DEFECTS; COMPLICATIONS; CLASSIFICATION; CLOSURE;

D O I：

10.1007/s00464-025-11557-z

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

BackgroundDespite high-level evidence that variations of surgical technique in laparoscopic Roux-en-Y gastric bypass (LRYGB) are correlated with postoperative outcomes and might be linked to intraoperative adverse events (iAEs), there are a paucity of studies analyzing iAEs in depth. The impact of surgical technique on the temporal occurrence of iAEs regarding phases and steps of LRYGB has not been studied so far. The objective of this study was to analyze the impact of variance in surgical technique on temporal occurrence, frequency, and type of iAEs in a multicentric dataset of LRYGB videos. MethodsMultiBypass140, a video dataset containing 70 LRYGB surgeries each from Strasbourg University Hospital (StrasBypass70) and Bern University Hospital (BernBypass70) was annotated with surgical phases, iAE type, and grade. The cumulative severity of iAEs per procedure was measured using the SEVERE score and correlated with procedure duration. ResultsSurgical technique significantly differed between StrasBypass70 and BernBypass70 (omentum division: 94% vs. 36%, p < 0.01; closure of mesenteric defects: 100% vs. 21%, p < 0.01). In MultiBypass140, a total of 797 iAEs were analyzed. The most iAE-prone phases were gastric pouch creation, gastrojejunal, and jejunojejunal anastomosis creation containing 77% (616/797) of all iAEs. StrasBypass70 showed significantly more iAEs in the omentum division (23 vs. 5, p < 0.01), Petersen space closure (13 vs. 1, p < 0.01), and mesenteric defect closure phases (34 vs. 1, p < 0.01) compared to BernBypass70. In both centers, SEVERE score was correlated with procedure duration. In BernBypass70, insufficient closure of anastomosis was significantly more frequent in patients with postoperative complications (0.2 +/- 0.6 vs. 0.0 +/- 0.1, p < 0.01). ConclusionVariations of the LRYGB technique between centers influence the temporal occurrence and frequency of iAEs. The frequency and severity of iAEs are correlated with procedure duration.

引用

页码：2026 / 2036

页数：11

共 32 条

[1] Intraoperative Adverse Events in Abdominal Surgery What Happens in the Operating Room Does Not Stay in the Operating Room [J].

Bohnen, Jordan D. ;

Mavros, Michael N. ;

Ramly, Elie P. ;

Chang, Yuchiao ;

Yeh, D. Dante ;

Lee, Jarone ;

De Moya, Marc ;

King, David R. ;

Fagenholz, Peter J. ;

Butler, Kathryn ;

Velmahos, George C. ;

Kaafarani, Haytham M. A. .

ANNALS OF SURGERY, 2017, 265 (06) :1119-1125

[2]

Brown W, 2022, 7 IFSO GLOBAL REGIST

[3] The Intraoperative Complications Assessment and Reporting with Universal Standards (ICARUS) Global Surgical Collaboration Project: Development of Criteria for Reporting Adverse Events During Surgical Procedures and Evaluating Their Impact on the Postoperative Course [J].

Cacciamani, Giovanni E. ;

Sholklapper, Tamir ;

Dell'Oglio, Paolo ;

Rocco, Bernardo ;

Annino, Filippo ;

Antonelli, Alessandro ;

Amenta, Michele ;

Borghesi, Marco ;

Bove, Pierluigi ;

Bozzini, Giorgio ;

Cafarelli, Angelo ;

Celia, Antonio ;

Leonardo, Costantino ;

Ceruti, Carlo ;

Cindolo, Luca ;

Crivellaro, Simone ;

Dalpiaz, Orietta ;

Falabella, Roberto ;

Falsaperla, Mario ;

Galfano, Antonio ;

Gallo, Farizio ;

Greco, Francesco ;

Minervini, Andrea ;

Parma, Paolo ;

Sighinolfi, Maria Chiara ;

Pastore, Antonio L. ;

Pini, Giovannalberto ;

Porreca, Angelo ;

Pucci, Luigi ;

Sciorio, Carmine ;

Schiavina, Riccardo ;

Umari, Paolo ;

Varca, Virginia ;

Veneziano, Domenico ;

Verze, Paolo ;

Volpe, Alessandro ;

Zaramella, Stefano ;

Lebastchi, Amir ;

Abreu, Andre ;

Mitropoulos, Dionysios ;

Biyani, Chandra Shekhar ;

Sotelo, Rene ;

Desai, Mihir ;

Artibani, Walter ;

Gill, Inderbir .

EUROPEAN UROLOGY FOCUS, 2022, 8 (06) :1847-1858

[4] Prolonged operative duration is associated with complications: a systematic review and meta-analysis [J].

Cheng, Hang ;

Clymer, Jeffrey W. ;

Chen, Brian Po-Han ;

Sadeghirad, Behnam ;

Ferko, Nicole C. ;

Cameron, Chris G. ;

Hinoul, Piet .

JOURNAL OF SURGICAL RESEARCH, 2018, 229 :134-144

[5] Surgery for weight loss in adults [J].

Colquitt, Jill L. ;

Pickett, Karen ;

Loveman, Emma ;

Frampton, Geoff K. .

COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2014, (08)

[6] Clinical Evaluation of Intraoperative Near Misses in Laparoscopic Rectal Cancer Surgery [J].

Curtis, Nathan J. ;

Dennison, Godwin ;

Brown, Chris S. B. ;

Hewett, Peter J. ;

Hanna, George B. ;

Stevenson, Andrew R. L. ;

Francis, Nader K. .

ANNALS OF SURGERY, 2021, 273 (04) :778-784

[7] Prospective validation of classification of intraoperative adverse events (ClassIntra): international, multicentre cohort study [J].

Dell-Kuster, Salome ;

Gomes, Nuno, V ;

Gawria, Larsa ;

Aghlmandi, Soheila ;

Aduse-Poku, Maame ;

Bissett, Ian ;

Blanc, Catherine ;

Brandt, Christian ;

ten Broek, Richard B. ;

Bruppacher, Heinz R. ;

Clancy, Cillian ;

Delrio, Paolo ;

Espin, Elo ;

Galanos-Demiris, Konstantinos ;

Gecim, Ethem ;

Ghaffari, Shahbaz ;

Gie, Olivier ;

Goebel, Barbara ;

Hahnloser, Dieter ;

Herbst, Friedrich ;

Orestis, Ioannidis ;

Joller, Sonja ;

Kang, Soojin ;

Martin, Rocio ;

Mayr, Johannes ;

Meier, Sonja ;

Murugesan, Jothi ;

Nally, Deirdre ;

Ozcelik, Menekse ;

Pace, Ugo ;

Passeri, Michael ;

Rabanser, Simone ;

Ranter, Barbara ;

Rega, Daniela ;

Ridgway, Paul F. ;

Rosman, Camie ;

Schmid, Roger ;

Schumacher, Philippe ;

Solis-Pena, Alejandro ;

Villarino, Laura ;

Vrochides, Dionisios ;

Engel, Alexander ;

O'Grady, Greg ;

Loveday, Benjamin ;

Steiner, Luzius A. ;

Van Goor, Harry ;

Bucher, Heiner C. ;

Clavien, Pierre-Alain ;

Kirchhoff, Philipp ;

Rosenthal, Rachel .

BMJ-BRITISH MEDICAL JOURNAL, 2020, 370

[8] Classification of surgical complications - A new proposal with evaluation in a cohort of 6336 patients and results of a survey [J].

Dindo, D ;

Demartines, N ;

Clavien, PA .

ANNALS OF SURGERY, 2004, 240 (02) :205-213

[9] EAES classification of intraoperative adverse events in laparoscopic surgery [J].

Francis, N. K. ;

Curtis, N. J. ;

Conti, J. A. ;

Foster, J. D. ;

Bonjer, H. J. ;

Hanna, G. B. .

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2018, 32 (09) :3822-3829

[10] Defining Global Benchmarks in Bariatric Surgery A Retrospective Multicenter Analysis of Minimally Invasive Roux-en-Y Gastric Bypass and Sleeve Gastrectomy [J].

Gero, Daniel ;

Raptis, Dimitri A. ;

Vleeschouwers, Wouter ;

van Veldhuisen, Sophie L. ;

San Martin, Andres ;

Xiao, Yao ;

Galvao, Manoela ;

Giorgi, Marcoandrea ;

Benois, Marine ;

Espinoza, Felipe ;

Hollyman, Marianne ;

Lloyd, Aaron ;

Hosa, Hanna ;

Schmidt, Henner ;

Garcia-Galocha, Jose Luis ;

van de Vrande, Simon ;

Chiappetta, Sonja ;

Lo Menzo, Emanuele ;

Aboud, Cristina Mamedio ;

Luthy, Sandra Gagliardo ;

Orchard, Philippa ;

Rothe, Steffi ;

Prager, Gerhard ;

Pournaras, Dimitri J. ;

Cohen, Ricardo ;

Rosenthal, Raul ;

Weiner, Rudolf ;

Himpens, Jacques ;

Torres, Antonio ;

Higa, Kelvin ;

Welbourn, Richard ;

Berry, Marcos ;

Boza, Camilo ;

Iannelli, Antonio ;

Vithiananthan, Sivamainthan ;

Ramos, Almino ;

Olbers, Torsten ;

Sepulveda, Matias ;

Hazebroek, Eric J. ;

Dillemans, Bruno ;

Staiger, Roxane D. ;

Puhan, Milo A. ;

Peterli, Ralph ;

Bueter, Marco .

ANNALS OF SURGERY, 2019, 270 (05) :859-867

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