The educating enigma: Does training level impact postoperative outcome in bariatric surgery?

Area of Science:

• Bariatric Surgery
• Surgical Outcomes
• Medical Education

Background:

• Bariatric procedures are complex with low public tolerance for complications.
• Evaluating bariatric surgery outcomes is crucial for patient safety and quality improvement.

Purpose of the Study:

• To determine the effect of surgical trainees on bariatric surgery outcomes.
• To analyze postoperative complications in relation to the presence and level of trainees.

Main Methods:

• Utilized the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database.
• Collected data on postoperative complications for 168,093 bariatric procedures in 2015.
• Analyzed complications against trainee presence (fellows, residents) using ANOVA.

Main Results:

• Fellow involvement correlated with longer operative times (117 min) compared to residents (105 min) and no trainees (85 min).
• Slightly higher rates of infections (2% vs 1%) and urinary tract infections (1% vs 0%) were observed with fellows.
• Prolonged hospital stays were noted with fellows (2.1 days) and residents (2.0 days) versus no trainees (1.8 days).

Conclusions:

• Fellow involvement led to increased operative times and mild, potentially clinically insignificant, increases in complications.
• Prolonged operating room time may contribute to the observed mild increases in postoperative complications.