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Kermansaravi M, Chiappetta S, Shikora SA, Musella M, Kow L, Aarts E, Abbas SI, Aly A, Aminian A, Angrisani L, Asghar ST, Bashir A, Behrens E, Billy H, Boza C, Brown WA, Caina DO, Carbajo MA, Chevallier JM, Clapp B, Cohen RV, Jazi AHD, De Luca M, Dilemans B, Fried M, Gagner M, Neto MG, Garneau PY, Gawdat K, Ghanem OM, Al Hadad M, Haddad A, ElFawal MH, Herrera MF, Higa K, Himpens J, Husain F, Kasama K, Kassir R, Khoursheed M, Khwaja H, Kristinsson JA, Kroh M, Kurian MS, Lakdawala M, LaMasters T, Lee WJ, Madhok B, Mahawar K, Mahdy T, Almomani H, Melissas J, Miller K, Neimark A, Omarov T, Palermo M, Papasavas PK, Parmar C, Pazouki A, Peterli R, Pintar T, Poggi L, Ponce J, Prasad A, Pratt JSA, Ramos AC, Rezvani M, Rheinwalt K, Ribeiro R, Ruiz-Ucar E, Sabry K, Safadi B, Shabbir A, ShahabiShahmiri S, Stenberg E, Suter M, Taha S, Taskin HE, Torres A, Verboonen S, Vilallonga R, Voon K, Wafa A, Wang C, Weiner R, Yang W, Zundel N, Prager G, Nimeri A. Metabolic and Bariatric Surgeon Criteria-An International Experts' Consensus. Obes Surg 2024:10.1007/s11695-024-07395-y. [PMID: 39046625 DOI: 10.1007/s11695-024-07395-y] [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: 04/10/2024] [Revised: 07/03/2024] [Accepted: 07/12/2024] [Indexed: 07/25/2024]
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.
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Affiliation(s)
- Mohammad Kermansaravi
- 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.
| | | | - Scott A Shikora
- Department of Surgery, Center for Metabolic and Bariatric Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mario Musella
- Advanced Biomedical Sciences Department, Federico II" University, Naples, Italy
| | - Lilian Kow
- Adelaide Bariatric Centre, Flinders University of South Australia, Adelaide, Australia
| | - Edo Aarts
- Weight Works Clinics and Allurion Clinics, Amersfoort, The Netherlands
| | | | - Ahmad Aly
- Austin and Repatriation Medical Centre, University of Melbourne, Heidelberg, VIC, Australia
| | - Ali Aminian
- Director, Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Luigi Angrisani
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | | | - Ahmad Bashir
- Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Amman, Jordan
| | | | - Helmuth Billy
- Ventura Advanced Surgical Associates, Ventura, CA, USA
| | - Camilo Boza
- Nutrition and Bariatric Center, Clinica Las Condes, Santiago de Chile, Chile
| | - Wendy A Brown
- Department of Surgery, Central Clinical School, Alfred Health, Monash University, Melbourne, VIC, Australia
| | - Daniel Oscar Caina
- Dr. Federico Abete Hospital for Trauma and Emergency, Obesity and Metabolic Center, Malvinas, Argentina
| | | | | | - Benjamin Clapp
- Department of Surgery, Texas Tech HSC Paul Foster School of Medicine, El Paso, TX, USA
| | - Ricardo V Cohen
- Center for the Treatment of Obesity and Diabetes, Hospital Alemão Oswaldo Cruz, Sao Paolo, Brazil
| | - Amir Hossein Davarpanah Jazi
- 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
| | | | - Bruno Dilemans
- Department of General Surgery, Sint Jan Brugge-Oostende, Brugge, AZ, Belgium
| | | | - Michel Gagner
- Department of Surgery, Westmount Square Surgical Center, Westmount, QC, Canada
| | | | - Pierre Y Garneau
- Division of Bariatric Surgery, CIUSSS-NIM, Montreal, Canada
- Department of Surgery, Université de Montréal, Montréal, Canada
| | - Khaled Gawdat
- Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Omar M Ghanem
- Division of Metabolic & Abdominal Wall Reconstructive Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Ashraf Haddad
- Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Amman, Jordan
| | | | - Miguel F Herrera
- Endocrine and Bariatric Surgery, UNAM at INCMNSZ, Mexico City, México
| | - Kelvin Higa
- Fresno Heart and Surgical Hospital, UCSF Fresno, Fresno, CA, USA
| | - Jaques Himpens
- Bariatric Surgery Unit, Delta Chirec Hospital, Brussels, Belgium
| | - Farah Husain
- University of Arizona College of Medicine, Phoenix, USA
| | - Kazunori Kasama
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Radwan Kassir
- Digestive and Bariatric Surgery Department, The View Hospital, Doha, Qatar
| | | | - Haris Khwaja
- Department of Bariatric and Metabolic Surgery, Chelsea and Westminster Hospital, London, UK
| | - Jon A Kristinsson
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Matthew Kroh
- Foregut Surgery and Surgical Endoscopy, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Marina S Kurian
- Department of Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Muffazal Lakdawala
- Department of General Surgery and Minimal Access Surgical Sciences, Sir H.N. Reliance Foundation Hospital, Mumbai, India
| | - Teresa LaMasters
- UnityPoint Clinic Weight Loss Specialists, West Des Moines, IA, USA
| | - Wei-Jei Lee
- Medical Weight Loss Center, China Medical University Shinchu Hospital, Zhubei City, Taiwan
| | - Brijesh Madhok
- East Midlands Bariatric and Metabolic Institute, University Hospital of Derby and Burton NHS Foundation Trust, Derby, DE22 3NE, UK
| | - Kamal Mahawar
- South Tyneside and Sunderland Foundation NHS Trust, Sunderland, UK
| | - Tarek Mahdy
- Department of Bariatric Surgery, Sharjah University, Sharjah, UAE
| | | | - John Melissas
- Bariatric Unit, Heraklion University Hospital, University of Crete, Crete, Greece
| | - Karl Miller
- Diakonissen Wehrle Private Hospital, Salzburg, Austria
| | - Alexander Neimark
- Laboratory of Surgery for Metabolic Disorders, Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - Taryel Omarov
- Department of Surgery, Azerbaijan Medical University, Baku, Azerbaijan
| | - Mariano Palermo
- Department of Surgery, Centro CIEN-Diagnomed, University of Buenos Aires, Buenos Aires, Argentina
| | - Pavlos K Papasavas
- Division of Metabolic and Bariatric Surgery, Hartford Hospital, Hartford, CT, USA
| | | | - Abdolreza Pazouki
- 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
| | - Ralph Peterli
- Department of Visceral Surgery, Clarunis-University Center for Gastrointestinal and Liver Diseases, St. Claraspital, and University Hospital Basel, Basel, Switzerland
| | - Tadeja Pintar
- Department of Abdominal Surgery and Medical Faculty, UMC Ljubljana, Ljubljana, Slovenia
| | - Luis Poggi
- Department of Surgery Clinica Anglo Americana, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Jaime Ponce
- Bariatric Surgery Program, CHI Memorial Hospital, Chattanooga, TN, USA
| | - Arun Prasad
- Department of Surgery, Indraprastha Apollo Hospitals, New Delhi, India
| | - Janey S A Pratt
- Department of Surgery, Stanford School of Medicine, VA Palo Alto Health Care System, 3801 Miranda Avenue, GS 112, Palo Alto, CA, 94304, USA
| | | | - Masoud Rezvani
- Department of Surgery, Davis Hwy, Inova Fair Oaks Hospital, JeffersonSuite 205, Woodbridge, VA, 14904, USA
| | | | - Rui Ribeiro
- Centro Multidisciplinar Do Tratamento da Obesidade, Hospital Lusíadas Amadora E Lisbon, Amadora, Portugal
| | - Elena Ruiz-Ucar
- Department of Bariatric and Endocrine Surgery, Fuenlabrada University Hospital, Madrid, Spain
| | - Karim Sabry
- Department of Surgery, Ain Shams University, Ain Shams, Egypt
| | | | - Asim Shabbir
- National University of Singapore, Singapore, Singapore
| | - Shahab ShahabiShahmiri
- 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
| | - Erik Stenberg
- Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Michel Suter
- Department of Surgery, Riviera-Chablais Hospital, Rennaz, Switzerland
| | - Safwan Taha
- Mediclinic Hospital Airport Road, Abu Dhabi, UAE
| | - Halit Eren Taskin
- Department of Surgery, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Antonio Torres
- Professor of Surgery, Department of Surgery, Hospital Clínico San Carlos, Complutense University of Madrid, Calle del Prof Martín Lagos, S/N, 28040, Madrid, Spain
| | | | - Ramon Vilallonga
- Endocrine, Bariatric, and Metabolic Surgery Department, University Hospital Vall Hebron, Barcelona, Spain
| | - Kelvin Voon
- Department of General Surgery, Penang General Hospital, George Town, Penang, Malaysia
| | - Ala Wafa
- Aljazeera International Hospital, Misurata University School of Medicine, Misurata, Libya
| | - Cunchuan Wang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | | | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Natan Zundel
- Department of Surgery, State University of New York, Buffalo, NY, USA
| | - Gerhard Prager
- Department of Surgery, Vienna Medical University, Vienna, Austria
| | - Abdelrahman Nimeri
- 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
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