Abstract
BackgroundStandardization of the key measurements of a procedure’s finished anatomic configuration strengthens surgical practice, research, and patient outcomes. A consensus meeting was organized to define standard versions of 25 bariatric metabolic procedures.MethodsA panel of experts in bariatric metabolic surgery from multiple continents was invited to present technique descriptions and outcomes for 4 classic, or conventional, and 21 variant and emerging procedures. Expert panel and audience discussion was followed by electronic voting on proposed standard dimensions and volumes for each procedure’s key anatomic alterations. Consensus was defined as ≥ 70% agreement.ResultsThe Bariatric Metabolic Surgery Standardization World Consensus Meeting (BMSS-WOCOM) was convened March 22–24, 2018, in New Delhi, India. Discussion confirmed heterogeneity in procedure measurements in the literature. A set of anatomic measurements to serve as the standard version of each procedure was proposed. After two voting rounds, 22/25 (88.0%) configurations posed for consideration as procedure standards achieved voting consensus by the expert panel, 1 did not attain consensus, and 2 were not voted on. All configurations were voted on by ≥ 50% of 50 expert panelists. The Consensus Statement was developed from scientific evidence collated from presenters’ slides and a separate literature review, meeting video, and transcripts. Review and input was provided by consensus panel members.ConclusionsStandard versions of the finished anatomic configurations of 22 surgical procedures were established by expert consensus. The BMSS process was undertaken as a first step in developing evidence-based standard bariatric metabolic surgical procedures with the aim of improving consistency in surgery, data collection, comparison of procedures, and outcome reporting.
Highlights
The work of the scientist is essentially to measure. –A
The consensus expert panel was comprised of procedure innovators, renowned proponents of procedures, and bariatric metabolic surgery subject experts drawn from representative geographic areas
Summarized tallies reflect the percentage of attendees who voted on a given standard
Summary
The work of the scientist is essentially to measure. –A. Szent-Györgyi, 1937 Nobel Prize in Physiology or MedicineWe are metabolic surgeons working in an era of evidencebased medicine. We must perform the exact technical procedure we agreed to perform for each patient; as surgical scientists, we must report a consistent technique in the international research literature to facilitate reproducibility and comparison of results. Establishing agreed standard measurements for the primary anatomic alterations performed in an operation ensures a level of scientific uniformity that strengthens surgical practice, research, and patient outcomes. The best technique is the most effective and safe approach at a given time It can only be learned from the evidence of formal research, which depends on collection of precise, reliable data. Bariatric metabolic procedures are complex and, especially require that exact intraoperative measurements of the final anatomic configurations be agreed upon and consistently employed. Standardization of the key measurements of a procedure’s finished anatomic configuration strengthens surgical practice, research, and patient outcomes.
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