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Laparoscopic Roux-en-Y gastric bypass at a Veterans Affairs and high-volume academic facilities: a comparison of institutional outcomes.

Alami RS, Morton JM, Sanchez BR, Curet MJ, Wren SM, Safadi BY

Department of Surgery, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave., 112G, Palo Alto, CA 94303, USA.

BACKGROUND: Outcomes of bariatric surgery have been linked to institutional case volume. The objective of our study was to compare outcome of laparoscopic Roux-en-y gastric bypass (RYGB) in 2 settings: a low-volume Veterans Affairs (VA) and a high-volume university hospital (UH). METHODS: Over a period of 27 months, 140 patients underwent RYGB (137 laparoscopic, 3 open) performed by 1 surgeon. Fifty-five were performed at a VA and 85 at a UH with an annual caseload close to 300. RESULTS: The body mass index in both groups was similar, but patients at the VA were older, mostly men, and more likely to have hypertension (HTN), obstructive sleep apnea, and diabetes mellitus (DM). Operative and anesthesia times were significantly longer at the VA. There were no differences in 30-day mortality (none), major morbidity, conversion rates, or reoperation rates. CONCLUSION: Laparoscopic RYGB can be performed safely at a VA facility despite a higher risk population and low annual volume.

Published 17 October 2005 in Am J Surg, 190(5): 821-5.
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