Original article Use of individual surgeon versus surgical team approach: surgical outcomes of laparoscopic Roux-en-Y gastric bypass in an Asian Medical Center Wency Chen, M.D. a,b , Chi-Chang Chang, M.D. c , Herng-Chia Chiu, Ph.D. d , Asim Shabbir, M.D. e , Daw-Shyong Perng, M.D. f , Chih-Kun Huang, M.D. e,g, * a Department of Community Medicine, E-Da Hospital, Yan-Chau Shiang, Kaohsiung City, Taiwan b Department of Healthcare Administration, I-Shou University, Kaohsiung City, Taiwan c Department of Obstetrics and Gynecology, E-Da Hospital, Yan-Chau Shiang, Kaohsiung City, Taiwan d Graduate Institute of Healthcare Administration, Kaohsiung Medical University, Kaohsiung City, Taiwan e Bariatric and Metabolic International Surgery Center, E-Da Hospital, Yan-Chau Shiang, Kaohsiung City, Taiwan f Department of Gastroenterology, E-Da Hospital, Yan-Chau Shiang, Kaohsiung City, Taiwan g International Minimally Invasive Surgery Training Center, E-Da Hospital, Yan-Chau Shiang, Kaohsiung City, Taiwan Received September 16, 2010; accepted February 17, 2011 Abstract Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been shown to improve both the health and the quality of life of morbidly obese patients. We compared the efficacy and safety of using a team approach to LRYGB versus an individual surgeon at a medical center. Methods: Data were collected from 200 consecutive patients undergoing LRYGB for morbid obesity from August 2005 to February 2008. Groups 1 and 2 included 50 patients each who underwent surgery and were cared for by the same surgeon. Group 3 included the next 100 consecutive patients, who underwent LRYGB by the same surgeon but who were cared for by a dedicated bariatric team. Results: For the 76 men (38%) and 124 women (62%) in the study, the excess weight loss at 1 and 3 months of follow-up did not differ; however, it was significantly different at 6 and 12 months. At the mean follow-up period, 30% of group 1, 6% of group 2, and 8% of group 3 had experienced complications. Most complications in group 1 occurred early and were related to the surgical technique; however, in groups 2 and 3, the complications related to the technique were markedly reduced. Men were 4.57 times as likely as women to experience complications related to bariatric surgery. Conclusion: A team-based approach is a better option for patients undergoing LRYGB than care by a single surgeon. With an experienced bariatric surgeon, the team approach resulted in shorter operative times and shorter hospital stays, with the same rate of complications. (Surg Obes Relat Dis 2012;8:214 –219.) Crown Copyright © 2012 Published by Elsevier Inc. on behalf of American Society for Metabolic and Bariatric Surgery. All rights reserved. Keywords: Laparoscopic Roux-en-Y gastric bypass; Morbid obesity; Learning curve; Team-based management of bariatric surgery; Weight loss The prevalence of obesity in Taiwan is 19.2% in men and 13.4% in women [1]. Chu [2] reviewed the national preva- lence of obesity in Taiwan and reported a steady increase in the prevalence of obesity, especially among children and men, from 1980 to 2000. Surgical intervention has been shown to improve both the health and the quality of life of morbidly obese patients [3]. Christou et al. [4] reported that, *Correspondence: Chih-Kun Huang, M.D., Bariatric and Metabolic International Surgery Center, E-Da Hospital, International Minimally In- vasive Surgery Training Center, E-Da Hospital, E-Da Road, Jian-Shu Tsuen, Yan-Chau Shiang, Kaohsiung County 824 Taiwan. E-mail: dr.ckhuang@hotmail.com Surgery for Obesity and Related Diseases 8 (2012) 214 –219 1550-7289/12/$ – see front matter Crown Copyright © 2012 Published by Elsevier Inc. on behalf of American Society for Metabolic and Bariatric Surgery. All rights reserved. doi:10.1016/j.soard.2011.02.011