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Introduction
Laparoscopic Roux-en-Y gastric bypass is a technically challenging operation with a long learning curve. We and others have previously shown that the learning curve is approximately 75-100 operations, and that the learning curve is associated with prolonged operative times and increased major complication rates1-2. Our aim was to determine how fellowship training impacts peri-operative outcomes during the learning curve. ... We chose to compare groups of 75 because our previous research has demonstrated the learning curve for LGB to be approximately 75 procedures1.
All patients met the minimal criteria for bariatric surgery proposed by the NIH Consensus Development Panel report of 19913. Patients having a history of previous bariatric procedures or previous gastric surgery were excluded. ...
The Group A surgeon completed a one-year laparoscopic surgery fellowship. ...
The Group B surgeon did not complete a laparoscopic surgery fellowship. ... Perioperative complications were considered to be any adverse event occurring within 30 days of surgery. ...
Postoperative care
Patients began ambulating the day of surgery. Clear liquids were generally begun at a rate of 2 oz/h the day after surgery. This rate was usually advanced to 4 oz/h on the second day after surgery. Patients were typically discharged 2 or 3 days after surgery. ... Group A patients had their drains removed 7-10 days after surgery.
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