Surgical resident training program to perform laparoscopic bariatric procedures: Are safety and postoperative outcomes compromised?

• Published in: Cirugia española (English ed.) 2021-03, Vol.99 (3), p.200-207
• Main Authors: Sebastián-Tomás, Juan Carlos, Navarro-Martínez, Sergio, Peris-Tomás, Nuria, Díez-Ares, José Ángel, Gonzálvez-Guardiola, Paula, Periañez-Gómez, Dolores, Martínez-Mas, Ezequiel, Trullenque-Juan, Ramón
• Format: Article
• Language: English
• Subjects: Bypass gástrico laparoscópico; Complicaciones; Complications; Curva de aprendizaje; Formación; Laparoscopic gastric bypass; Learning curve; Residentes; Residents; Training
• ISSN: 2173-5077; 2173-5077
• DOI: 10.1016/j.cireng.2021.02.025

[Display omitted] Laparoscopic bariatric procedures such as laparoscopic Roux-en-Y gastric bypass (LRYGB) are technically demanding and require a long learning curve. Little is known about whether surgical resident (SR) training programs to perform these procedures are safe and feasible. This study aims to evaluate the results of our SR training program to perform LRYGB. We designed a retrospective study including patients with LRYGB between January 2014 and December 2018, comparing SR results to experienced bariatric surgeons (EBS). In our country, SR have a five-year surgical formative period, and in the fourth year they are trained for 6 months in our bariatric surgery unit, from January to June. In the beginning, they perform different steps of this procedure, to finally complete an LRYGB. We collected demographic data, comorbidities, intraoperative outcomes, and postoperative complications and outcomes after a one-year follow-up. Two hundred and eight patients were eligible for inclusion: 67 in group I (SR), and 141 in group II (EBS). Both groups were comparable. There was no statistically significant difference in operating time (166.45 min in group I vs. 156.69 min in group II; P = 0.156). Conversion to open surgery, hospital stay, postoperative complications, and short-term outcomes had no significant differences between the two groups. There was no mortality registered during this period. Implementation of LRYGB stepwise learning as part of an SR training program is safe, and results are comparable to EBS, without loss of efficiency. Therefore, it is feasible to train SR in bariatric surgery under EBS supervision. El objetivo de este estudio es evaluar los resultados de nuestro programa de formación de residentes para la realización de bypass gástrico laparoscópico en Y de Roux (BGLYR). Estudio retrospectivo en el que se incluyeron pacientes a los que se les realizó un BGLYR en nuestro centro durante el período comprendido entre enero de 2014 y diciembre de 2018. Los residentes de cuarto año de nuestro centro realizaron progresivamente distintos pasos de la intervención siempre tutorizados por cirujanos bariátricos expertos (CBE). Se compararon los resultados obtenidos en las intervenciones en las que el residente ha realizado algún paso o la totalidad del BGLYR (grupo I), con aquellas realizadas en su totalidad por CBE (grupo II). Se analizaron datos demográficos de los pacientes, comorbilidades, resultados intraoperatorios, morbimortalidad posto