The technique a surgeon uses while operating can vary greatly, even among trained practitioners, leading to extensive differences in patient outcomes, according to a new study. Conducting a peer review of surgical video may be a valuable way to evaluate surgical technique, allowing for targeted education, coaching and quality improvement.

Dr. Chhabra and his colleagues reviewed whether it was possible to objectively evaluate surgical technique, and whether variation in surgical technique would have meaningful association with clinical outcomes. More specifically, the researchers explored how variations in sleeve gastrectomy surgery can affect patient health.

For this study, surgeons from the Michigan Bariatric Surgery Collaborative were asked to submit representative videos of themselves performing a sleeve gastrectomy for morbid obesity. A total of 30 surgeons submitted 46 videos, collected from Jan. 1, 2015, to Dec. 31, 2016. The videos were then peer reviewed, with the surgeons evaluating each on key technical components of the procedure, and rating the skill level of the surgeon in each video via the Objective Structured Assessment of Technical Skills tailored for bariatric surgery. Patient outcomes also were obtained from medical records, focusing on results from 30 days, and one, two and three years after surgery. The team found a wide variance in the use of surgical techniques with corresponding weight loss, levels of gastroesophageal reflux disease and risk for hemorrhage.

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