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Advanced laparoscopic bariatric surgery Is safe in general surgery training
John Kuckelman1, Jason Bingham1, Morgan Barron1
1Department of Surgery, Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, WA, USA.
American Journal of Surgery
|April 2, 2017
Summary
General surgery residents can safely perform laparoscopic bariatric surgery. Resident involvement in these procedures does not significantly impact operative time or leak rates when supervised by an attending surgeon.
Area of Science:
- Bariatric Surgery
- Surgical Education
- Minimally Invasive Surgery
Background:
- Bariatric surgery training is increasing within general surgery programs.
- Concerns exist regarding resident involvement in complex bariatric procedures.
- This study evaluates patient outcomes in resident-performed laparoscopic bariatric surgery.
Purpose of the Study:
- To assess the safety and outcomes of laparoscopic bariatric procedures performed by general surgery residents.
- To determine if resident experience impacts operative time and leak rates.
- To evaluate the effectiveness of attending surgeon proctorship in resident-led bariatric surgery.
Main Methods:
- Retrospective review of 1649 laparoscopic bariatric procedures over seven years.
- Procedures were primarily performed by general surgery residents under attending surgeon proctorship.
- Key outcomes included operative volume, operative time, and leak rate.
Main Results:
- A total of 1649 procedures were analyzed, including laparoscopic bypass and sleeve gastrectomy.
- The overall leak rate was 0.67% (18 leaks).
- No significant differences in operative time or leak rate were observed across different resident training levels.
Conclusions:
- General surgery residents can safely execute laparoscopic bariatric procedures.
- Attending surgeon proctorship ensures that resident training level does not adversely affect leak rates.
- Resident involvement in laparoscopic bariatric surgery is safe and effective.