title: Advanced laparoscopic bariatric surgery Is safe in general surgery training.
abstract: BACKGROUND
  Bariatric surgery makes up an increasing percentage of general surgery training. The safety of resident involvement in these complex cases has been questioned. We evaluated patient outcomes in resident performed laparoscopic bariatric procedures.
  
  
  METHODS
  Retrospective review of patients undergoing a laparoscopic bariatric procedure over seven years at a tertiary care single center. Procedures were primarily performed by a general surgery resident and proctored by an attending surgeon. Primary outcomes included operative volume, operative time and leak rate with perioperative outcomes evaluated as secondary outcomes.
  
  
  RESULTS
  A total of 1649 bariatric procedures were evaluated. Operations included laparoscopic bypass (690) and laparoscopic sleeve gastrectomy (959). Average operating time was 136 min. Eighteen leaks (0.67%) were identified. Graduating residents performed an average of 89 laparoscopic bariatric cases during their training. There were no significant differences between resident levels with concern to operative time or leak rate (p 0.97 and p = 0.54).
  
  
  CONCLUSIONS
  General surgery residents can safely perform laparoscopic bariatric surgery. When proctored by a staff surgeon, a resident's level of training does not significantly impact leak rate.
authors.affiliation: Department of Surgery, Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, WA, USA. Electronic address: john.kuckelman@gmail.com.
authors.forename: John
authors.initials: J
authors.lastname: Kuckelman
authors.affiliation: Department of Surgery, Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, WA, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Bingham
authors.affiliation: Department of Surgery, Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, WA, USA.
authors.forename: Morgan
authors.initials: M
authors.lastname: Barron
authors.affiliation: Department of Surgery, Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, WA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Lallemand
authors.affiliation: Department of Surgery, Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, WA, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Martin
authors.affiliation: Department of Surgery, Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, WA, USA.
authors.forename: Vance
authors.initials: V
authors.lastname: Sohn
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000193:education* / Q000379:methods; D002983:Clinical Competence; D005260:Female; D005500:Follow-Up Studies; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000193:education*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D016896:Treatment Outcome; D014861:Washington