Auto Suture

Training Summary

Gastric bypass surgery is a life-changing event for patients. Surgeons should be committed to the preoperative and long-term care required by obesity surgery patients. Surgeons are encouraged to follow the American Society of Bariatric Surgeons (ASBS) and Society for American Gastrointestinal Endoscopic Surgeons (SAGES) joint "Guidelines for Laparoscopic and Conventional Treatment of Morbid Obesity" and the SAGES "Guidelines for Framework for Post-Residency Surgical Education and Training". Institutions should follow the American College of Surgeons (ACS) "Recommendations for Facilities Performing Bariatric Surgery" that includes recommendations for staffing, operating room and hospital facilities.

Training Steps

United States Surgical advocates that surgeons interested in bariatric surgery become members of the ASBS and take the ASBS Essentials of Bariatric Surgery course (1) (There is also an Essential of Bariatric Surgery for Allied Health personnel). The surgeon should have advanced laparoscopic skills (2) such as extensive experience with laparoscopic fundoplications. The surgeon should also attend a one or two day course through the ASBS, SAGES or at one of our Centers of Excellence (3). Many of these courses overlap with regard to association and accreditation. The institution should follow the ACS guidelines for establishing a bariatric surgery facility (4).

Once a site or surgeon has qualified, USS will support precepting and proctoring (5a and 5b).

Precepting – A preceptorship is where the trainee travels to an established LGB site and observes the activities at the site.
Proctoring – A proctorship consists of the trainer traveling to a trainee’s site to observe the initial LGB cases.

Advanced Training

The preceptorship and proctoring programs have been designed to accommodate the functional level of the participating trainee, that is the training is tailored to the trainee. Preceptorships can last from 1 day to two weeks, however, most last from 3 to 5 days. Proctoring usually lasts one or two days.


Type of Training	Duration	Activities	Target Attendees

Preceptorship	1 day	LGB Case observation	Advanced Laparoscopist is joining or already with an established open bariatric program First Assistant

Preceptorship	2-3 days	LGB Case and bariatric program observation Inanimate skills laboratory Animate skills laboratory	Advanced Laparoscopist starting bariatric program First Assistant Allied Health

Preceptorship	3-5 days	LGB Case and bariatric program observation -Inanimate skills laboratory	Advanced Laparoscopist starting bariatric program Bariatric Surgeon with good laparascopic skills First Assistant Allied Health

Mini-Fellowship*	1-6 weeks	LGB Case and bariatric program observation Inanimate/animate skills laboratory Procedural participation as first assist followed by primary surgeon	Bariatric surgeon requiring advanced laparoscopic skills

Proctorship†	1-2 days	Proctor observes LGB cases at trainees institution	Advanced Laparoscopist is joining or already with an established open bariatric program Surgeon who has completed Preceptorship above

* - Participation in surgery requires licensing and temporary privileges at the precepting institution. Precepting institutions arrange this. Participants within the same state do not require additional licensing. † - The preceptor may participate in surgery if privileges and licensing can be arranged.

Procedure

Instrumentation

Room Set-Up

Patient Info

Resources

Training