title: Use of individual surgeon versus surgical team approach: surgical outcomes of laparoscopic Roux-en-Y gastric bypass in an Asian Medical Center.
abstract: BACKGROUND
  Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been shown to improve both the health and the quality of life of morbidly obese patients. We compared the efficacy and safety of using a team approach to LRYGB versus an individual surgeon at a medical center.
  
  
  METHODS
  Data were collected from 200 consecutive patients undergoing LRYGB for morbid obesity from August 2005 to February 2008. Groups 1 and 2 included 50 patients each who underwent surgery and were cared for by the same surgeon. Group 3 included the next 100 consecutive patients, who underwent LRYGB by the same surgeon but who were cared for by a dedicated bariatric team.
  
  
  RESULTS
  For the 76 men (38%) and 124 women (62%) in the study, the excess weight loss at 1 and 3 months of follow-up did not differ; however, it was significantly different at 6 and 12 months. At the mean follow-up period, 30% of group 1, 6% of group 2, and 8% of group 3 had experienced complications. Most complications in group 1 occurred early and were related to the surgical technique; however, in groups 2 and 3, the complications related to the technique were markedly reduced. Men were 4.57 times as likely as women to experience complications related to bariatric surgery.
  
  
  CONCLUSIONS
  A team-based approach is a better option for patients undergoing LRYGB than care by a single surgeon. With an experienced bariatric surgeon, the team approach resulted in shorter operative times and shorter hospital stays, with the same rate of complications.
authors.affiliation: Department of Community Medicine, E-Da Hospital, Yan-Chau Shiang, Kaohsiung City, Taiwan.
authors.forename: Wency
authors.initials: W
authors.lastname: Chen
authors.forename: Chi-Chang
authors.initials: CC
authors.lastname: Chang
authors.forename: Herng-Chia
authors.initials: HC
authors.lastname: Chiu
authors.forename: Asim
authors.initials: A
authors.lastname: Shabbir
authors.forename: Daw-Shyong
authors.initials: DS
authors.lastname: Perng
authors.forename: Chih-Kun
authors.initials: CK
authors.lastname: Huang
mesh_terms: D000328:Adult; D052938:Bariatric Medicine / Q000458:organization & administration* / Q000592:standards; D002983:Clinical Competence / Q000592:standards*; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D010348:Patient Care Team / Q000458:organization & administration*; D011183:Postoperative Complications / Q000209:etiology; D012307:Risk Factors; D016896:Treatment Outcome