title: Impact of minimally invasive/bariatric surgery fellowship on perioperative complications and outcomes in the first year of practice.
abstract: BACKGROUND
  Several reports have described worse perioperative outcomes of laparoscopic gastric bypass procedure during learning curve, which improved after completion of one-year fellowship training.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the immediate impact of fellowship training on perioperative complications and outcomes of various bariatric procedures.
  
  
  METHODS
  One hundred initial patients who underwent laparoscopic gastric banding, laparoscopic Roux-en-Y gastric bypass, laparoscopic vertical sleeve gastrectomy, and robotically-assisted laparoscopic biliopancreatic diversion with duodenal switch by a single fellowship trained surgeon were analyzed.
  
  
  RESULTS
  Overall average Body Mass Index (BMI) of the patients was 45.9 kg/m(2), age was 47.5 years, and the American Society of Anesthesiologist Score was 2.89. There were no intraoperative, major 30-day complications, or open conversions. Average operative time was 62 minutes in gastric banding, 160 minutes in gastric bypass, 119 minutes in vertical sleeve gastrectomy, and 320 minutes in biliopancreatic diversion. Length of stay ranged from 0.5 day after gastric banding to 3.9 days after biliopancreatic diversion. The perioperative complications and outcomes are comparable with those reported by experienced surgeons. No mortality occurred in this series.
  
  
  CONCLUSIONS
  Bariatric fellowship ensured skills acquisition for new surgeons to safely and effectively perform various types of bariatric operations, with minimal perioperative complications and excellent outcomes.
authors.affiliation: Department of Surgery, Abington Memorial Hospital, Abington, PA, USA.
authors.forename: Iswanto
authors.initials: I
authors.lastname: Sucandy
authors.forename: Gintaras
authors.initials: G
authors.lastname: Antanavicius
keywords: Complications; Fellowship; Impact; Outcomes
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