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Can an advanced laparoscopic fellowship program be established without compromising the center's outcomes?

Shanu N Kothari¹, William C Boyd, Pamela J Lambert

¹Department of Surgery, Gundersen Lutheran Health System, La Crosse, Wisconsin, USA. snkothar@gundluth.org

Surgical Innovation

|November 28, 2008

Summary

Establishing a laparoscopic gastric bypass (LGB) fellowship program did not negatively impact patient outcomes like weight loss or complications. The only significant difference observed was a training-related increase in operative time post-fellowship.

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Area of Science:

Bariatric Surgery
Surgical Education
Minimally Invasive Surgery

Background:

Academic community hospitals are increasingly adopting minimally invasive bariatric programs.
Fellowship training is crucial for advancing specialized surgical techniques like laparoscopic gastric bypass (LGB).
Assessing the impact of fellowship programs on surgical outcomes is essential for quality improvement.

Purpose of the Study:

To evaluate the effect of implementing an advanced laparoscopic fellowship program on laparoscopic gastric bypass (LGB) outcomes.
To compare patient outcomes before and after the establishment of the LGB fellowship.

Main Methods:

Retrospective review of a prospectively maintained bariatric surgery database.
Comparison of patient demographics, length of stay, excess weight loss, complication rates, and operative times.

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Analysis of LGB procedures performed pre-fellowship and post-fellowship.

Main Results:

No significant differences were found in patient demographics, length of stay, percentage excess weight loss, or complication rates between prefellowship and postfellowship groups.
The mean operative time for LGB increased significantly post-fellowship (154 minutes) compared to prefellowship (123 minutes).
This increase in operative time was attributed to the training nature of the fellowship program.

Conclusions:

Establishing an advanced laparoscopic fellowship with an emphasis on LGB is feasible and safe.
The fellowship program can be implemented without compromising patient outcomes for laparoscopic gastric bypass.
Increased operative time is an expected and acceptable outcome associated with surgical fellowship training.