Original articleInfluence of median surgeon operative duration on adverse outcomes in bariatric surgery☆
Section snippets
Data sources and study population
The MBSC is a payor-funded consortium of hospitals and surgeons who perform bariatric surgery in Michigan. The collaborative collects data on nearly all patients undergoing bariatric surgery in the state each year, and utilizes center-specific outcomes feedback and quarterly collaborative meetings to promote quality improvement and best practices among participating surgeons and hospitals. The specifics of data collection and patient follow-up have been detailed elsewhere [12], [13], [14].
In
Results
A total of 16,344 patients underwent primary laparoscopic Roux-en-Y gastric bypass by 34 surgeons during the study period. Table 1 details the baseline characteristics of surgeons included in the study cohort, according to tercile of median surgeon operative time. Compared to surgeons in the fastest tercile, surgeons in the slowest tercile required 53 additional minutes to complete a gastric bypass procedure [median (interquartile range) 139 (133–150) versus 86 (69–91), P<.001]. A much higher
Discussion
This is the first population-based study to investigate the influence of surgeon median operative time on outcomes after complex laparoscopic surgery. In this analysis, we found that patients undergoing laparoscopic Roux-en-Y gastric bypass by slower surgeons have greater odds of any complication, prolonged length of stay and VTE, even after accounting for patient and surgeon characteristics, and the complex interactions between median surgeon operative time, gastrojejunostomy technique and
Disclosures
Dr. John Birkmeyer is chief scientific officer and has an equity interest in ArborMetrix Inc, which provides software and analytics for measuring hospital quality and efficiency. The company had no role in this study. All remaining authors have no conflicts of interest.
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Dr. Reames is supported by a grant from the National Cancer Institute (5 T32 CA009672-23). This funding source had no involvement in the manuscript herein.