Faculty Collaboration Database

Surgical skill in bariatric surgery: Does skill in one procedure predict outcomes for another? Surgery 2016 Nov;160(5):1172-1181

Date

10/30/2016

Pubmed ID

27324569

Pubmed Central ID

PMC5086297

DOI

10.1016/j.surg.2016.04.033

Scopus ID

2-s2.0-84994895375 (requires institutional sign-in at Scopus site)   19 Citations

Abstract

BACKGROUND: Recent data establish a strong link between peer video ratings of surgical skill and clinical outcomes with laparoscopic gastric bypass. Whether skill for one bariatric procedure can predict outcomes for another related procedure is unknown.

METHODS: Twenty surgeons voluntarily submitted videos of a standard laparoscopic gastric bypass procedure, which was blindly rated by 10 or more peers using a modified version of the Objective Structured Assessment of Technical Skills. Surgeons were divided into quartiles for skill in performing gastric bypass, and within 30 days of sleeve gastrectomy, their outcomes were compared. Multivariate logistic regression analysis was utilized to adjust for patient risk factors.

RESULTS: Surgeons with skill ratings in the top (n = 5), middle (n = 10, middle 2 combined), and bottom (n = 5) quartiles for laparoscopic gastric bypass saw similar rates of surgical and medical complications after laparoscopic sleeve gastrectomy (top 5.7%, middle 6.4%, bottom 5.5%, P = .13). Furthermore, surgeons' skill ratings did not correlate with rates of reoperation, readmission, and emergency department visits. Top-rated surgeons had significantly faster operating room times for sleeve gastrectomy (top 76 minutes, middle 90 minutes, bottom 88 minutes; P < .001) and a higher annual volume of bariatric cases per year (top 240, middle 147, bottom 105; P = .001).

CONCLUSION: Video ratings of surgical skill with laparoscopic gastric bypass do not predict outcomes of laparoscopic sleeve gastrectomy. Evaluation of surgical skill with one procedure may not apply to other related procedures and may require independent assessment of surgical technical proficiency.

Author List

Varban OA, Greenberg CC, Schram J, Ghaferi AA, Thumma JR, Carlin AM, Dimick JB, Michigan Bariatric Surgery Collaborative

Author

Amir Ghaferi MD President, Phys Enterprise & SAD Clinical Affairs in the Medical College Physicians Administration department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Bariatric Surgery
Clinical Competence
Female
Gastrectomy
Gastric Bypass
Gastroplasty
Health Care Surveys
Humans
Laparoscopy
Male
Middle Aged
Obesity, Morbid
Postoperative Complications
Risk Assessment
Surveys and Questionnaires
Treatment Outcome
United States
Video Recording