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Lau C, van Kesteren C, Smeenk RM. A Dutch Survey on Medication Adjustments after Metabolic and Bariatric Surgery: Experiences of Bariatric Surgeons, Internists, Pharmacists, and General Practitioners. Obes Surg 2024; 34:1778-1785. [PMID: 38565826 PMCID: PMC11031431 DOI: 10.1007/s11695-024-07197-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 03/20/2024] [Accepted: 03/20/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND As metabolic and bariatric surgery (MBS) can alter the pharmacokinetics of drugs, post-bariatric surgery patients may require medication adjustments and monitoring. To improve pharmacotherapy in these patients, we aimed to understand the beliefs, attitudes, knowledge, and concerns of healthcare professionals who treat these patients. METHODS A survey by means of an online questionnaire was divided into six sections. It was sent to bariatric surgeons, internists, pharmacists, and general practitioners in the Netherlands. RESULTS Out of 229 returned surveys, 222 were included. Virtually all respondents (98%) expected MBS to influence the effect of medication. Both reduced efficacy (23%) and more adverse events or medication-related complications (21%) were recognized. Two-thirds of the respondents felt competent to prescribe or to provide advice regarding medication in post-bariatric surgery patients. Most of the respondents (95%) believed that other healthcare professionals should be aware of the contraindication "bariatric surgery". Of the respondents, 37% indicated that they were not aware of the medication advice incorporated in the electronic health record systems. Almost half of the respondents (48%) indicated that they documented changes in drug effects. Most respondents answered that these ought to be registered in the pharmacovigilance database or national registry. CONCLUSIONS The majority of prescribers and pharmacists believe that patients will receive better pharmacotherapy if healthcare professionals take MBS into account. However, not all prescribers think they are competent to act adequately. To improve this, information on changed drug effects after MBS should be more widely shared among healthcare professionals via resources that are easily accessible.
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Affiliation(s)
- Cedric Lau
- Department of Clinical Pharmacy, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
- Department of Pharmacy and Pharmacology, Antoni Van Leeuwenhoek Hospital/The Netherlands Cancer Institute, Amsterdam, The Netherlands.
- Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | | | - Robert M Smeenk
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
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Felsenreich DM, Yang W, Taskin HE, Abdelbaki T, Shahabi S, Zakeri R, Talishinskiy T, Gero D, Neimark A, Chiappetta S. Young-IFSO Bariatric/Metabolic Surgery Training and Education Survey. Obes Surg 2023; 33:2816-2830. [PMID: 37505341 DOI: 10.1007/s11695-023-06751-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND This international Young-IFSO survey aims to address variations, trends, and obstacles in bariatric/metabolic surgery (BMS) training globally, since expectations and resources differ among young surgeons. METHODS The Young-IFSO scientific team designed an online confidential questionnaire with 50 questions analyzing the individual BMS training. The survey link was sent to all IFSO/ASMBS members and was shared in social media. All Young-IFSO members (age up to 45 years) were invited to participate between 16 December 2022 and 4 February 2023. RESULTS A total of 240 respondents from 61 countries took the survey. Most respondents (70.24%) described their current position as a consultant surgeon with an average of 5.43 years' experience working in BMS, and 55% are working in a bariatric center of excellence. More than 50% of the respondents performed none or less than 10 BMS during residency. Preparation of the stomach and stapling during sleeve gastrectomy (SG) were the first steps performed, and SG was the first BMS completed as a first operating surgeon by most of the respondents (74%). In total, 201 (84.45%) surgeons reported to perform scientific work. Most respondents (90.13%) reported that surgical mentorship had improved their surgical skills. CONCLUSION This international experts' survey underlines the lack of a standardized global surgical curriculum of BMS during residency. It shows that SG is the single most performed procedure by young surgeons. These data might underline the importance of advancing surgical education in BMS, and accredited fellowship programs should be offered globally to maintain and raise quality of BMS.
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Affiliation(s)
- Daniel M Felsenreich
- Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria.
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Halit E Taskin
- Bariatric Surgery Center, Department of Surgery, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Tamer Abdelbaki
- General Surgery Department, Alexandria University, Faculty of Medicine, Alexandria, Egypt
| | - Shahab Shahabi
- Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Minimally Invasive Surgery Research Center, Rasool-E Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Roxanna Zakeri
- Department of Upper GI Surgery, University College London Hospital NHS Foundation Trust, London, UK
| | - Toghrul Talishinskiy
- Bariatric Surgery Minimally Invasive and Robotic Surgery, St. Joseph's University Medical Center, Paterson, USA
| | - Daniel Gero
- Department of Surgery and Transplantation, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Alexandr Neimark
- Almazov National Medical Research Centre, Saint-Petersburg, Russia
| | - Sonja Chiappetta
- Bariatric and Metabolic Surgery Unit, Department of General Surgery, Ospedale Evangelico Betania, Via Argine 604, 80147, Naples, Italy.
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Blackham RE, Hamdorf JM. Video-Rated Performance Assessment of Simulated Laparoscopic Sleeve Gastrectomy: Validation of a Sleeve Gastrectomy Rating Scale. Obes Surg 2021; 31:3188-3193. [PMID: 33895975 DOI: 10.1007/s11695-021-05422-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE The global rise in obesity has been accompanied by widespread uptake of the procedure of laparoscopic sleeve gastrectomy. Despite this, the key components for performance assessment have not been standardized for this procedure. The aim of this study was to develop and demonstrate the validity of a Sleeve Objective Structured Assessment of Technical Skill (SOSATS) scale for learning the procedure of laparoscopic sleeve gastrectomy (LSG). MATERIALS AND METHODS The SOSATS evaluation tool was based upon critical steps of the LSG procedure. Both the SOSATS and the Global Rating Scale (GRS) component of the Objective Structured Assessment of Technical Skill (OSATS) tools were utilized in a prospective single-blinded observational study design of 26 video recordings of surgeons performing sleeve gastrectomies using a novel simulation. The surgeons were allocated into "novice" or "experienced" groups dependent on case-volume criteria. Surgical performance was assessed using both the GRS and SOSATS scales by blinded assessors of the video recordings. RESULTS Face and content validity were demonstrated for key components of the simulated model. An overall positive correlation was established inferring concurrent validity between the accepted OSATS Global Rating Scale against the SOSATS procedural scale. Construct validity was established for a number of areas of the SOSATS scale. CONCLUSION The SOSATS scale is shown to exhibit construct and concurrent validity in the simulated setting for the procedure of sleeve gastrectomy. Utilizing this scale to review surgical performance is potentially feasible and reliable but would require further research prior to use in high-stakes assessment processes such as credentialing.
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Affiliation(s)
- Ruth E Blackham
- CTEC, Medical School, The University of Western Australia, Perth, Western Australia. .,Western Surgical Health, Nedlands, Western Australia.
| | - Jeffrey M Hamdorf
- CTEC, Medical School, The University of Western Australia, Perth, Western Australia.,Western Surgical Health, Nedlands, Western Australia
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Danion J, Donatini G, Breque C, Oriot D, Richer JP, Faure JP. Bariatric Surgical Simulation: Evaluation in a Pilot Study of SimLife, a New Dynamic Simulated Body Model. Obes Surg 2020; 30:4352-4358. [PMID: 32621055 PMCID: PMC7333933 DOI: 10.1007/s11695-020-04829-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/25/2020] [Accepted: 06/25/2020] [Indexed: 01/16/2023]
Abstract
Background The demand for bariatric surgery is high and so is the need for training future bariatric surgeons. Bariatric surgery, as a technically demanding surgery, imposes a learning curve that may initially induce higher morbidity. In order to limit the clinical impact of this learning curve, a simulation preclinical training can be offered. The aim of the work was to assess the realism of a new cadaveric model for simulated bariatric surgery (sleeve and Roux in Y gastric bypass). Aim A face validation study of SimLife, a new dynamic cadaveric model of simulated body for acquiring operative skills by simulation. The objectives of this study are first of all to measure the realism of this model, the satisfaction of learners, and finally the ability of this model to facilitate a learning process. Methods SimLife technology is based on a fresh body (frozen/thawed) given to science associated to a patented technical module, which can provide pulsatile vascularization with simulated blood heated to 37 °C and ventilation. Results Twenty-four residents and chief residents from 3 French University Digestive Surgery Departments were enrolled in this study. Based on their evaluation, the overall satisfaction of the cadaveric model was rated as 8.52, realism as 8.91, anatomic correspondence as 8.64, and the model’s ability to be learning tool as 8.78. Conclusion The use of the SimLife model allows proposing a very realistic surgical simulation model to realistically train and objectively evaluate the performance of young surgeons.
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Affiliation(s)
- J. Danion
- ABS LAB, University Medical School of Poitiers, rue de la Milétrie, Bâtiment D1, TSA 51115, 86073 Poitiers Cedex, France
- Departemant of Visceral, Digestif and Endocrine Surgery, University Hospital of Poitiers, 2 rue de la Miletrie, BP 577, 86021 Poitiers Cedex, France
| | - G. Donatini
- ABS LAB, University Medical School of Poitiers, rue de la Milétrie, Bâtiment D1, TSA 51115, 86073 Poitiers Cedex, France
- Departemant of Visceral, Digestif and Endocrine Surgery, University Hospital of Poitiers, 2 rue de la Miletrie, BP 577, 86021 Poitiers Cedex, France
| | - C. Breque
- ABS LAB, University Medical School of Poitiers, rue de la Milétrie, Bâtiment D1, TSA 51115, 86073 Poitiers Cedex, France
| | - D. Oriot
- ABS LAB, University Medical School of Poitiers, rue de la Milétrie, Bâtiment D1, TSA 51115, 86073 Poitiers Cedex, France
| | - J. P. Richer
- ABS LAB, University Medical School of Poitiers, rue de la Milétrie, Bâtiment D1, TSA 51115, 86073 Poitiers Cedex, France
- Departemant of Visceral, Digestif and Endocrine Surgery, University Hospital of Poitiers, 2 rue de la Miletrie, BP 577, 86021 Poitiers Cedex, France
| | - J. P. Faure
- ABS LAB, University Medical School of Poitiers, rue de la Milétrie, Bâtiment D1, TSA 51115, 86073 Poitiers Cedex, France
- Departemant of Visceral, Digestif and Endocrine Surgery, University Hospital of Poitiers, 2 rue de la Miletrie, BP 577, 86021 Poitiers Cedex, France
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