Abstract
There have been few reports of improved perioperative outcomes for laparoscopic gastric bypass in the surgeon’s independent practice following completion of fellowship training but none from outside of USA. The aim was to evaluate the impact of fellowship training on perioperative outcomes for gastric bypass in the first year as consultant surgeon. Data of all patients undergoing primary bariatric procedures by the author were extracted from prospectively maintained database. Patients who underwent laparoscopic sleeve gastrectomy and gastric banding were excluded. Data on patient demographics, operative time, conversion to open, length of stay, 30-day complications and mortality were analysed. The Obesity Surgery Mortality Risk Score (OS-MRS) was used for risk stratification. The risk score and perioperative outcomes were compared to mentors’ post-learning curve results from host training institution. Out of 83 primary bariatric procedures performed, 74 (63 females, 11 males) were gastric bypasses in first year. The mean age was 45.1 (25–66) years and body mass index was 47.7 (36–57) kg/m2. There were no immediate postoperative complications, no conversions to open surgery and no mortality. One patient was re-admitted within 30 days (1.4%) with small bowel obstruction following internal hernia and needed re-laparoscopy. As compared with host training institution, the OS-MRS distribution and perioperative outcomes of the author did not differ significantly from that of mentors’ post-learning curve results. Bariatric fellowship ensured skills acquisition for the author to safely and effectively perform gastric bypass without any learning curve and with surgical outcomes similar to that of experienced mentor at host training institution. Fellowships should be an essential part of bariatric training worldwide.
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Acknowledgements
I would like to acknowledge Samrat Mukherjee and Richard Bevan-Jones for their help in statistical analysis of data in Tables 2, 3 and 4. I am very grateful to my colleagues, K Mannur and Y Koak, as well as other team members for their support at the Homerton University Hospital. Finally, I am also grateful to my mentors’, R Welbourn and D Mahon, at Musgrove Park Hospital for their kind support during my fellowship training.
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The author declares that he has no conflict of interest.
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Agrawal, S. Impact of Bariatric Fellowship Training on Perioperative Outcomes for Laparoscopic Roux-en-Y Gastric Bypass in the First Year as Consultant Surgeon. OBES SURG 21, 1817–1821 (2011). https://doi.org/10.1007/s11695-011-0482-2
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DOI: https://doi.org/10.1007/s11695-011-0482-2