Metabolic and Bariatric Surgeon Criteria-An International Experts' Consensus

Kermansaravi M 1 , Chiappetta S 2 , Shikora SA 3 , Musella M 4 , Kow L 5 , Aarts E 6 Show all authors , Abbas SI 7 , Aly A 8 , Aminian A 9 , Angrisani L 10 , Asghar ST 11 , Bashir A 12 , Behrens E 13 , Billy H 14 , Boza C 15 , Brown WA 16 , Caina DO 17 , Carbajo MA 18 , Chevallier JM 19 , Clapp B 20 , Cohen RV 21 , Jazi AHD 22 , De Luca M 23 , Dilemans B 24 , Fried M 25 , Gagner M 26 , Neto MG 27 , Garneau PY 28 , Gawdat K 29 , Ghanem OM 30 , Al Hadad M 31 , Haddad A 12 , ElFawal MH 32 , Herrera MF 33 , Higa K 34 , Himpens J 35 , Husain F 36 , Kasama K 37 , Kassir R 38 , Khoursheed M 39 , Khwaja H 40 , Kristinsson JA 41 , Kroh M 42 , Kurian MS 43 , Lakdawala M 44 , LaMasters T 45 , Lee WJ 46 , Madhok B 47 , Mahawar K 48 , Mahdy T 49 , Almomani H 50 , Melissas J 51 , Miller K 52 , Neimark A 53 , Omarov T 54 , Palermo M 55 , Papasavas PK 56 , Parmar C 57 , Pazouki A 22 , Peterli R 58 , Pintar T 59 , Poggi L 60 , Ponce J 61 , Prasad A 62 , Pratt JSA 63 , Ramos AC 64 , Rezvani M 65 , Rheinwalt K 66 , Ribeiro R 67 , Ruiz-Ucar E 68 , Sabry K 69 , Safadi B 70 , Shabbir A 71 , ShahabiShahmiri S 22 , Stenberg E 72 , Suter M 73 , Taha S 74 , Taskin HE 75 , Torres A 76 , Verboonen S 77 , Vilallonga R 78 , Voon K 79 , Wafa A 80 , Wang C 81 , Weiner R 82 , Yang W 81 , Zundel N 83 , Prager G 84 , Nimeri A 85

Affiliations 

  • 1 Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat-E Fatemeh Hospital, Iran University of Medical Sciences, Tehran, Iran. mkermansaravi@yahoo.com
  • 2 Ospedale Evangelico Betania, Naples, Italy. drschiappetta@gmail.com
  • 3 Department of Surgery, Center for Metabolic and Bariatric Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
  • 4 Advanced Biomedical Sciences Department, Federico II" University, Naples, Italy
  • 5 Adelaide Bariatric Centre, Flinders University of South Australia, Adelaide, Australia
  • 6 Weight Works Clinics and Allurion Clinics, Amersfoort, The Netherlands
  • 7 Iranian Hospital, Alwasl Road, Dubai, UAE
  • 8 Austin and Repatriation Medical Centre, University of Melbourne, Heidelberg, VIC, Australia
  • 9 Director, Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA
  • 10 Department of Public Health, Federico II University of Naples, Naples, Italy
  • 11 Capital Hospital, CDA, Islamabad, Pakistan
  • 12 Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Amman, Jordan
  • 13 New Life Center, Guatemala, Guatemala
  • 14 Ventura Advanced Surgical Associates, Ventura, CA, USA
  • 15 Nutrition and Bariatric Center, Clinica Las Condes, Santiago de Chile, Chile
  • 16 Department of Surgery, Central Clinical School, Alfred Health, Monash University, Melbourne, VIC, Australia
  • 17 Dr. Federico Abete Hospital for Trauma and Emergency, Obesity and Metabolic Center, Malvinas, Argentina
  • 18 , Valladolid, Spain
  • 19 Université Paris 5, Paris, France
  • 20 Department of Surgery, Texas Tech HSC Paul Foster School of Medicine, El Paso, TX, USA
  • 21 Center for the Treatment of Obesity and Diabetes, Hospital Alemão Oswaldo Cruz, Sao Paolo, Brazil
  • 22 Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat-E Fatemeh Hospital, Iran University of Medical Sciences, Tehran, Iran
  • 23 Department of General Surgery, Rovigo Hospital, Rovigo, Italy
  • 24 Department of General Surgery, Sint Jan Brugge-Oostende, Brugge, AZ, Belgium
  • 25 OB Clinic, Prague, Czech Republic
  • 26 Department of Surgery, Westmount Square Surgical Center, Westmount, QC, Canada
  • 27 Endovitta Institute, São Paulo, Brazil
  • 28 Division of Bariatric Surgery, CIUSSS-NIM, Montreal, Canada
  • 29 Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
  • 30 Division of Metabolic & Abdominal Wall Reconstructive Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA
  • 31 Bariatric and Metabolic Surgery Centre, Healthpoint, Abu Dhabi, UAE
  • 32 Makassed General Hospital, Beirut, Lebanon
  • 33 Endocrine and Bariatric Surgery, UNAM at INCMNSZ, Mexico City, México
  • 34 Fresno Heart and Surgical Hospital, UCSF Fresno, Fresno, CA, USA
  • 35 Bariatric Surgery Unit, Delta Chirec Hospital, Brussels, Belgium
  • 36 University of Arizona College of Medicine, Phoenix, USA
  • 37 Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
  • 38 Digestive and Bariatric Surgery Department, The View Hospital, Doha, Qatar
  • 39 Taiba Hospital, Kuwait City, Kuwait
  • 40 Department of Bariatric and Metabolic Surgery, Chelsea and Westminster Hospital, London, UK
  • 41 Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
  • 42 Foregut Surgery and Surgical Endoscopy, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA
  • 43 Department of Surgery, New York University Grossman School of Medicine, New York, NY, USA
  • 44 Department of General Surgery and Minimal Access Surgical Sciences, Sir H.N. Reliance Foundation Hospital, Mumbai, India
  • 45 UnityPoint Clinic Weight Loss Specialists, West Des Moines, IA, USA
  • 46 Medical Weight Loss Center, China Medical University Shinchu Hospital, Zhubei City, Taiwan
  • 47 East Midlands Bariatric and Metabolic Institute, University Hospital of Derby and Burton NHS Foundation Trust, Derby, DE22 3NE, UK
  • 48 South Tyneside and Sunderland Foundation NHS Trust, Sunderland, UK
  • 49 Department of Bariatric Surgery, Sharjah University, Sharjah, UAE
  • 50 NMC Royal Hospital, Abu Dhabi, UAE
  • 51 Bariatric Unit, Heraklion University Hospital, University of Crete, Crete, Greece
  • 52 Diakonissen Wehrle Private Hospital, Salzburg, Austria
  • 53 Laboratory of Surgery for Metabolic Disorders, Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
  • 54 Department of Surgery, Azerbaijan Medical University, Baku, Azerbaijan
  • 55 Department of Surgery, Centro CIEN-Diagnomed, University of Buenos Aires, Buenos Aires, Argentina
  • 56 Division of Metabolic and Bariatric Surgery, Hartford Hospital, Hartford, CT, USA
  • 57 Whittington Hospital, London, UK
  • 58 Department of Visceral Surgery, Clarunis-University Center for Gastrointestinal and Liver Diseases, St. Claraspital, and University Hospital Basel, Basel, Switzerland
  • 59 Department of Abdominal Surgery and Medical Faculty, UMC Ljubljana, Ljubljana, Slovenia
  • 60 Department of Surgery Clinica Anglo Americana, Universidad Nacional Mayor de San Marcos, Lima, Peru
  • 61 Bariatric Surgery Program, CHI Memorial Hospital, Chattanooga, TN, USA
  • 62 Department of Surgery, Indraprastha Apollo Hospitals, New Delhi, India
  • 63 Department of Surgery, Stanford School of Medicine, VA Palo Alto Health Care System, 3801 Miranda Avenue, GS 112, Palo Alto, CA, 94304, USA
  • 64 Institute for Metabolic Optimization, Sao Paulo, Brazil
  • 65 Department of Surgery, Davis Hwy, Inova Fair Oaks Hospital, JeffersonSuite 205, Woodbridge, VA, 14904, USA
  • 66 St. Franziskus Hospital, Cologne, Germany
  • 67 Centro Multidisciplinar Do Tratamento da Obesidade, Hospital Lusíadas Amadora E Lisbon, Amadora, Portugal
  • 68 Department of Bariatric and Endocrine Surgery, Fuenlabrada University Hospital, Madrid, Spain
  • 69 Department of Surgery, Ain Shams University, Ain Shams, Egypt
  • 70 Aman Hospital, Doha, Qatar
  • 71 National University of Singapore, Singapore, Singapore
  • 72 Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
  • 73 Department of Surgery, Riviera-Chablais Hospital, Rennaz, Switzerland
  • 74 Mediclinic Hospital Airport Road, Abu Dhabi, UAE
  • 75 Department of Surgery, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
  • 76 Professor of Surgery, Department of Surgery, Hospital Clínico San Carlos, Complutense University of Madrid, Calle del Prof Martín Lagos, S/N, 28040, Madrid, Spain
  • 77 Obesity Goodbye Center, Tijuana, Mexico
  • 78 Endocrine, Bariatric, and Metabolic Surgery Department, University Hospital Vall Hebron, Barcelona, Spain
  • 79 Department of General Surgery, Penang General Hospital, George Town, Penang, Malaysia
  • 80 Aljazeera International Hospital, Misurata University School of Medicine, Misurata, Libya
  • 81 Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
  • 82 Sana Clinic Offenbach, Offenbach, Germany
  • 83 Department of Surgery, State University of New York, Buffalo, NY, USA
  • 84 Department of Surgery, Vienna Medical University, Vienna, Austria
  • 85 Department of Surgery, Center for Metabolic and Bariatric Surgery, Brigham and Women's Hospital, Director of Bariatric and Metabolic Surgery, Harvard Medical School, Boston, MA, USA
Obes Surg, 2024 Jul 24.
PMID: 39046625 DOI: 10.1007/s11695-024-07395-y

Abstract

PURPOSE: With the global epidemic of obesity, the importance of metabolic and bariatric surgery (MBS) is greater than ever before. Performing these surgeries requires academic training and the completion of a dedicated fellowship training program. This study aimed to develop guidelines based on expert consensus using a modified Delphi method to create the criteria for metabolic and bariatric surgeons that must be mastered before obtaining privileges to perform MBS.

METHODS: Eighty-nine recognized MBS surgeons from 42 countries participated in the Modified Delphi consensus to vote on 30 statements in two rounds. An agreement/disagreement among ≥ 70.0% of the experts was regarded to indicate a consensus.

RESULTS: Consensus was reached on 29 out of 30 statements. Most experts agreed that before getting privileges to perform MBS, surgeons must hold a general surgery degree and complete or have completed a dedicated fellowship training program. The experts agreed that the learning curves for the various operative procedures are approximately 25-50 operations for the LSG, 50-75 for the OAGB, and 75-100 for the RYGB. 93.1% of experts agreed that MBS surgeons should diligently record patients' data in their National or Global database.

CONCLUSION: MBS surgeons should have a degree in general surgery and have been enrolled in a dedicated fellowship training program with a structured curriculum. The learning curve of MBS procedures is procedure dependent. MBS surgeons must demonstrate proficiency in managing postoperative complications, collaborate within a multidisciplinary team, commit to a minimum 2-year patient follow-up, and actively engage in national and international MBS societies.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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