Making the Choice
What should I look for in a surgeon?
This is the most important step in the decision tree to have bariatric surgery or not. For it is this step that will determine what outcomes and complications you will occur if any, and whether or not they can be managed effectively and safely should they arise.
Studies clearly show that a surgeon who has dedicated, greater than 75% of their surgical volume to bariatrics and being fellowship trained are the two top considerations in choosing the right surgeon.
The American Society of Metabolic and Bariatric Surgeons (ASMBS) has built into its Centers of Excellence program that an individual surgeon must have completed a minimum number of cases per annum (50) and has completed a historical number of cases over their lifetime (125) for the surgeon to be classified as a COE surgeon.
Does the hospital matter?
Linked to the individual surgical volume is the hospital volume, unless you are having a same day procedure, then the quality of the hospital staff and anesthesia department is equally important. Just as with the surgeon you would want to go to the hospital that performs a significant volume of surgeries per annum and has good outcomes. Again, the ASMBS has defined the number of surgeries as 125 per year as the minimal number of cases a hospital or surgery center can perform and still remain excellent. The rationale for these qualifications is that if the surgery is performed routinely the surgeon and hospital staff can complete procedures with full consistency. The American College of Surgeons, who facilitate the Centers of Excellence for Bariatric Surgery, emphasizes the symbiotic relationship of the surgeon & hospital team. This can but is not limited through standardized orders,GASTRIC SLEEVE stringent credentialing processes, regular quality review, and regular meetings to ensure continued education of all staff involved in the care of a bariatric patient.
How long will I be in the hospital?
Depending on the modality performed, laparoscopic or open, your hospital stay can range from 1 to 2 overnights.The actual time spent in the hospital will depend upon your personal medical
Does Centers of Excellence Matter?
Although recent articles differ as to the significance of the Centers of Excellence designation, it is clear form looking at their certification criteria, the designation should give insight as to how well the surgeon and hospital maintain care for bariatric patients.The benefit of the two primary accrediting bodies the Surgical Review Corporation (SRC) and the American College of Surgeons (ACS) may goes beyond the parchment to the data. Both of these institutions require an exhaustive and comprehensive reporting of patient data that is sent relayed to data repositories.
The SRC uses Bariatric Longitudinal Outcomes Database (BOLD) as their proprietary repository. The data that has been accumulated since its inception has lead to several advances thwarting many of the myths that impeded patients ability to access and obtain bariatric surgery.
The safety of bariatric surgery was once falsely reported as far higher than it was in reality. With the use of the data available from BOLD it has been shown that the incidence of death from a bariatric procedure such as a RYGB is lower than that of having oneʼs gallbladder removed. This aggregate information works to provide better analysis in a similar way google instant finds popular listings.
Another and less tangible benefit of the COE programs is that it offers protection from surgeons that may only performs surgery sporadically and have uncertain outcomes. This will be achieved by the private and government payers that will require COE designation through their entity, SRC or ACS.
A good analogy COE designation would be a car emblem, yes you can have a lemon from any manufacturer but it is less likely with a highly reputed emblem. Look for the COE designation it will clue you in on the quality programs in your area.