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

The objective of this study is to assess the impact of establishing a fellowship training program on a center's laparoscopic gastric bypass (LGB) outcomes. The authors compare their prefellowship and postfellowship LGB outcomes by means of retrospective review of a prospectively maintained bariatric database. Theirs is an academic community hospital that instituted a minimally invasive bariatric program in 2001 and an advanced laparoscopic fellowship with emphasis in laparoscopic gastric bypass in 2003. Participants were patients undergoing LGB from the inception of the program. All prefellowship LGBs were performed and assisted by the same surgeon and assistant. Results show that prefellowship and postfellowship patient demographics were similar. The mean length of stay was 2.17 and 2.35 days, respectively. The percentage excess weight loss was 72% and 72%, respectively (p = 0.990). Major or minor complication rates were not significantly different between groups. The prefellowship operative time was 123 +/- 22 minutes, compared with 154 +/- 28 minutes postfellowship (P = .001). In conclusion, a training-related increase in operative time was the only difference in the 2 groups. An advanced laparoscopic fellowship training program with emphasis in LGB can be safely established without compromising the center's LGB outcomes.