Individual surgeon versus surgical team approach

Use of individual surgeon versus surgical team approach: surgical outcomes of laparoscopic Roux-en-Y gastric bypass in an Asian Medical Center

Received 16 September 2010; accepted 17 February 2011. published online 14 March 2011.

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.

Conclusion

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.

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