Background: Standardization 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. Methods: A 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. Results: The 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. Conclusions: Standard 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.
Bibliographical noteFunding Information:
Funding This work was supported by Sri Aurobindo Institute of Medical Sciences (SAIMS), Indore, MP, India. J.N. Buchwald received a grant for manuscript development from SAIMS, Indore, MP, India.
We are very grateful for the planning, preparatory work, and extensive support of the local organizing committee: Dr. Vinod Bhandari (Founding Chairman, SAIMS Medical College and Postgraduate Institution, Indore, MP, India), Dr. Manjushree Bhandari (Chairperson, SAIMS Medical College and Postgraduate Institution, Indore, MP, India), Dr. RR Wavare (Dean, SAIMS Medical College and Postgraduate Institution, Indore, MP, India), Shantanu Bhagdikar, Mahak Bhandari, Sachin Kale, Arun Mishra, Nilesh Mishra, Winnie Mathur, Manoj Reddy, Himanshu Shrivastava, and Abhishek Tiwari. We greatly appreciate the guidance and contribution in the planning of the meeting and reviewing the consensus statement by the Scientific Advisory Committee: Dr. Pradeep Chowbey, Dr. John Dixon, Dr. Kamal Mahawar, Dr. David Cummings, Dr. Abdelrahman Nimeri, Dr. Eric DeMaria, Dr. Michel Gagner, Dr. Natan Zundel, and Dr. Henry Buchwald. We thank the SAIMS Foundation for their generous sponsorship of the World Consensus Meeting on Standardization of Bariatric Metabolic Procedures and associated statement development. We also especially thank Ngwebifor Fobi for her expert meeting organization and management.
© 2019, The Author(s).
- Bariatric surgery
- Gastric bypass
- Metabolic surgery
- Sleeve gastrectomy
- Surgical technique
- Type 2 diabetes