Mostafa Mohammad, Bader Raneem, Asfour George, Imam Ashraf, Miller Rafael, Sapojnikov Shimon, Zakai Barak-Bar, Khalayleh Harbi
Department of Surgery, Kaplan Medical Center, Rehovot and the Hebrew University Medical School, Jerusalem, Israel.
The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Surg Endosc. 2025 Apr 23. doi: 10.1007/s00464-025-11698-1.
Limited data are available on the safety and outcomes of LSG performed by senior surgical residents (SSR). This study aimed to compare the outcomes of laparoscopic sleeve gastrectomy (LSG) performed by SSR under the supervision of a senior bariatric surgeon (SBS) with those performed solely by SBS.
We retrospectively analyzed patients who underwent LSG. Patients were divided into two groups: Consultant group surgery performed using SBS. Supervised resident group comprised surgeries performed by SSR under the supervision of SBS. Data collected included demographics, body mass index (BMI), excessive body weight loss (EBWL), complications, and follow-up results.
Of the 480 patients, 350 (72.9%) underwent surgery by SBS (Consultant Group), and 130 (27.1%) by SSR with supervision (Supervised resident Group). Operative times were longer in supervised resident group (104.13 min) than in consultant group (82.63 min, P < 0.001). Early complications occurred in 3.1% of the cases, with no significant difference between the groups. Postoperative BMI and EBWL showed slightly better short-term results in supervised resident group, although differences diminished in the long term.
LSG performed using SSR under the supervision of SBS is safe and effective. While operative times were longer for residents, short-term outcomes were comparable and there were no adverse effects on long-term results. These findings support the integration of LSG training into surgical residency programs.
LSG can be safely performed using SSR with appropriate supervision, with no detrimental impact on the outcomes. This highlights the feasibility of involving residents in LSG while maintaining a high standard of care.
关于高级外科住院医师（SSR）实施腹腔镜袖状胃切除术（LSG）的安全性和结果的数据有限。本研究旨在比较在高级减重外科医生（SBS）监督下由SSR实施的LSG与仅由SBS实施的LSG的结果。
我们回顾性分析了接受LSG的患者。患者分为两组：顾问组手术由SBS实施。监督住院医师组包括在SBS监督下由SSR实施的手术。收集的数据包括人口统计学、体重指数（BMI）、过多体重减轻（EBWL）、并发症和随访结果。
480例患者中，350例（72.9%）由SBS实施手术（顾问组），130例（27.1%）由SSR在监督下实施手术（监督住院医师组）。监督住院医师组的手术时间（104.13分钟）比顾问组长（82.63分钟，P<0.001）。3.1%的病例发生早期并发症，两组之间无显著差异。术后BMI和EBWL在监督住院医师组的短期结果略好，尽管长期差异减小。
在SBS监督下由SSR实施的LSG是安全有效的。虽然住院医师的手术时间较长，但短期结果相当，对长期结果没有不利影响。这些发现支持将LSG培训纳入外科住院医师培训项目。
在适当监督下，SSR可以安全地实施LSG，对结果没有不利影响。这突出了让住院医师参与LSG同时保持高标准护理的可行性。
