Do Early Outcomes of Sleeve Gastrectomy Improve the First Year After Completing a Bariatric Surgery Fellowship?

Background: It has been suggested that fellowship training can reduce patient morbidity and mortality related to the learning curve. There are limited data comparing the outcomes before and after bariatric surgery training. The aim of this study was to evaluate the impact of bariatric surgery fellowship training during a surgeon's early experience on perioperative outcomes. Methods: All patients who underwent sleeve gastrectomy (SG) by a single surgeon before and after bariatric surgery fellowship were included. Results: There were 49 and 117 patients who underwent SG before and after fellowship respectively. SG patients before fellowship were significantly younger 36.4 +/- 11.7 versus 42.3 +/- 14.6 years old (p = 0.01), with lower American Society of Anesthesiology score 2.1 +/- 0.3 versus 2.29 +/- 0.4 (p = 0.02). Intraoperative complications occurred in 1 (2.0%) versus 2 (1.7%) (p = n/s) before fellowship and after fellowship periods, respectively. There were no mortalities. The 30-day overall morbidity was 5 (10.2%) versus 4 (3.4%) (p = 0.07). Major complications were significantly lower after the fellowship; 1 (1.7%) versus 3 (6.1%) (p = 0.04). No significant differences in weight loss were found at the latest follow-up. Conclusions: Designated bariatric surgery training is associated with reduced major postoperative complications for SG. Surgeons should pursue a formal bariatric surgery training program before starting their practice.