A recent study believes that surgeons that are less skilled then their peers give their patients an increased risk of complications after leaving their operation room. Published in the New England Journal of Medicine on October 10, the study by the University of Michigan evaluated nearly 20 weight loss surgeons who volunteered to have their skills videotaped during weight loss surgery.
About the Study
All of the surgeons performed the same procedure, a laparoscopic gastric bypass surgery. While this is a fairly common yet complex surgery, outcomes varied across the board depending on the surgeon who performed the surgery. Each surgeon submitted a video of them performing the surgery and was then rated anonymously from one to five (one equates to the skill of a general surgeon to 5 which showcases the skill of an experienced surgeon). The surgeons were rated anywhere from an average of 2.6 to 4.8.
In conjunction with these ratings, the researchers revealed that the more lower-skilled surgeons have more postsurgical complications among their patients. These complications include (and are not limited to): infection, blood clots, heart attack, stroke, depression, vitamin deficiencies or intestinal blockages. While the researchers of the study understand that the risk of infection is prevalent with any surgery, it’s especially increased because of the chance of leaks with weight loss surgery.
After their analysis, they discovered that surgeons who were less skilled had a 14.5% rate of complications while those with better skills or more experience had a rate of just 5.2%. In order to determine these numbers, the researchers studied the follow-up data from nearly 10,000 of these surgeons’ patients.
The researchers also discovered that the lower-skilled and rated surgeons had an average surgery time of 137 minutes, while the higher-skilled and rated surgeons completed the surgery in just 98 minutes. Previous research has shown that the longer the operating time, the higher the risk of complications.
The researchers believe their findings will directly influence the evaluation process of medical school students and those who move on to become a surgeon. They also hope that their study will bring up the issue of recertification process for some surgeons who are practicing, but may need their skill rehoned. This process is currently influenced by having satisfactory performance on a multiple-choice test and by achieving a certain number of continuing medical education credits. While those things do show cognitive knowledge, it’s important that a surgeon can actually perform the procedures they are so knowledgeable about.
This study was the first to link surgical skill to that of clinical outcomes. The researchers believe it was successful because it raises more questions for other studies to answer. They believe their study points to the need to do more studies similar to this to understand how good surgeons achieve those skills – is it through knowledge or is it just genetic?
The researchers of the study suggest that those interested in bariatric surgery find referrals through their primary-care physicians. This trusted medical professional can provide you insight into who they know to be success in weight loss surgery as a result of their reputation and proven results. It’s important to trust who will be performing surgery on you and the decision-making process is vital to one’s overall weight loss success.