ArticleObesity surgery2016
A Challenge between Trainee Education and Patient Safety: Does Fellow Participation Impact Postoperative Outcomes Following Bariatric Surgery?
Article in Obesity surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Outcomes after bariatric surgery according to large databases: a systematic review.Langenbeck's archives of surgery · 2017Pooled it
- Postoperative outcomes of bariatric surgery performed by trainees: a retrospective single-centre study from a Swiss regional hospital.Langenbeck's archives of surgery · 2026Article
- Outcomes of laparoscopic sleeve gastrectomy performed by senior surgical residents as compared to bariatric surgeons.Surgical endoscopy · 2025Article
- Metabolic and Bariatric Surgeon Criteria-An International Experts' Consensus.Obesity surgery · 2024Article
- The Impact of Trainee Involvement on Outcomes in Metabolic and Bariatric Surgery.Obesity surgery · 2023Article
- Fellowship training influences learning curves for laparoscopic sleeve gastrectomy.Surgical endoscopy · 2022Article
- Complications and Readmissions Associated with First Assistant Training Level Following Elective Bariatric Surgery.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Surgical trainee impact on bariatric surgery safety.Surgical endoscopy · 2019Article
- The Presence of an Advanced Gastrointestinal (GI)/Minimally Invasive Surgery (MIS) Fellowship Program Does Not Impact Short-Term Patient Outcomes Following Fundoplication or Esophagomyotomy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2018Article
- The impact of fellowship surgical training on operative time and patient morbidity during robotics-assisted sacrocolpopexy.International urogynecology journal · 2018Article
- Variability in Bariatric Surgical Care Among Various Centers: a Survey of All Bariatric Surgeons in the Province of Quebec, Canada.Obesity surgery · 2018Article
- Resident Training in Bariatric Surgery-A National Survey in the Netherlands.Obesity surgery · 2017Article
- Large subcapsular hematoma following ureteroscopic laser lithotripsy of renal calculi in a spina bifida patient: lessons we learn.International medical case reports journal · 2016Article
- Safety and Outcomes of Laparoscopic Sleeve Gastrectomy in a General Surgery Residency Program.JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSurgical training may potentially influence patient care. A safe, high-quality bariatric and metabolic surgery practice requires dedicated and specialized training commonly acquired during a fellowship. This study evaluates the impact of fellow participation on early postoperative outcomes in bariatric surgery.
methodsFrom the American College of Surgeons (ACS-NSQIP) database, we identified all obese patients who had undergone primary laparoscopic Roux-en-Y gastric bypass (LRYGB) and sleeve gastrectomy (LSG) between 2010 and 2012. Logistic regression was used to prognosticate the surgical fellow (PGY-6, 7, or 8) participation in bariatric surgeries on perioperative outcomes, as compared to surgeries with no trainee participation.
resultsThe study cohort consisted of 10,838 patients (8819 LRYGB, 2019 LSG, 32 % fellow participation). Fellows participated in higher-risk surgeries. Fellow involvement was associated with increased operative time in LRYGB (difference 42.4 ± 1.2 min, p < 0.001) and in LSG (difference 38.8 ± 2.5 min, p < 0.001). Multivariate regression revealed that fellow involvement in LSG did not significantly alter postoperative adverse events. Conversely, in the LRYGB group, fellow participation was independently associated with higher rates of overall complications (OR = 1.37, 95 % CI 1.16-1.63), serious complications (OR = 1.23, 95 % CI 1.00-1.52), surgical complications (OR = 1.42; 95 % CI 1.17-1.73), and reoperation (OR = 1.43, 95 % CI 1.10-1.87). On adjusted analysis, while readmission was higher with fellow involvement in both procedures, mortality rates were comparable.
conclusionsFellow involvement resulted in a clinically appreciable increase in operative times. Fellow participation in the operating room was also independently associated with worse early postoperative outcomes following LRYGB, but was not the case for LSG. Promoting proficiency in surgical simulation laboratories and a gradual participation of fellows from LSG to LRYGB during fellowship may be associated with a reduction in postoperative complications.
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