Complications and Readmissions Associated with First Assistant Training Level Following Elective Bariatric Surgery

Area of Science:

• Bariatric Surgery
• Surgical Outcomes
• Medical Training

Background:

• Limited understanding of the impact of first assistant training levels in bariatric surgery.
• Need to assess the clinical significance of varying assistant experience on patient outcomes.

Purpose of the Study:

• To evaluate the association between the training level of the first assistant and 30-day postoperative complications and readmissions in bariatric surgery.
• To determine if the experience of the first assistant influences patient safety and recovery after bariatric procedures.

Main Methods:

• Analysis of the ACS-MBSAQIP database for elective bariatric procedures (2015-2016).
• Categorization of first assistants into training levels: attending, fellow, resident, physician assistant/nurse practitioner (PA/NP), and none.
• Multivariable logistic regression used to adjust for patient and procedural factors, examining 30-day death or serious morbidity (DSM) and readmission rates.

Main Results:

• Over 410,000 procedures were analyzed, with diverse first assistant training levels represented.
• Operative times were longer for fellow and resident first assistants.
• No statistically significant impact of first assistant training level on 30-day DSM or readmission rates was observed after adjustments.

Conclusions:

• The training level of the first assistant in bariatric surgery does not significantly affect 30-day postoperative outcomes.
• Patient outcomes are not negatively influenced by the inclusion of a diverse range of first assistant training levels.
• This finding offers reassurance regarding the safety of current bariatric surgical team compositions.