P.611

Relationship of a Technical Scoring System for Laparoscopic Sleeve

Gastrectomy and Clinical Safety

Michel Gagner2 Muthanna Asaad Mohammed Wajdi1 Yasser Fawzy Zidan1 1. National Center of Obecity, Mosul, Iraq; 2. IFSO, Montreal, QC, Canada

Introduction: Laparoscopic sleeve gastrectomy (LSG) produces excellent

results if performed properly, otherwise serious complications may occur.

Objectives: The aim of this study is to validate a technical scoring system for LSG and evaluate safety.

Methods: The proposed scoring system relies on essential steps taken from

videos of 10 expert bariatric surgeons (points for essential steps with penalty

to reach the final score); an excellent score above 80, good score (accepted and safe) 50-80, and a bad one bellow 50 (unsafe and unaccepted).

Results: Three groups of surgeons are involved in this study, proficient (A),

beginners that know the scoring system (B) and beginners that don’t know it (C).

The system was tested prospectively on (10) consecutive cases performed by

each group taking the average. Group (A) Scored 70.5 while group (B)

scored 51.8 (p-value0.0009) and in the last(2)cases the beginner scores were close to the proficient, group (C) scores 23.7(p-value0.0025).

The scoring system correlated with level of proficiency and mean operative

time which was 97.4, 137.4 and 177 minutes in different groups (p-value 0.0010 and 0.0125 respectively). The plateau was achieved in case number

(6) for group (B) while for group (C) the plateau was not identified.

In group (C) one case of mortality and (3) cases of conversion were recorded

(2 strictures and 1 bleeding). Conclusion: This scoring system proved to be effective, applicable and

shows that higher proficiency score correlated with faster operating time,

and lesser serious morbidity.