IFSO Worldwide Survey 2016: Primary, Endoluminal, and Revisional Procedures

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Abstract

The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO), being a Federation of 62 national societies, is the ideal network to monitor the number and type of procedures at a global level. The IFSO survey, enriched with a special section on revisional procedures, aims to report the number and types of bariatric procedures performed worldwide in 2016 and analyzes the surgical trends from 2008 to 2016.

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Metabolic/bariatric surgery worldwide 2011.

Henry Buchwald, Danette Oien (2013)

Metabolic/bariatric procedures for the treatment of morbid obesity, as well as for type 2 diabetes, are among the most commonly performed gastrointestinal operations today, justifying periodic assessment of the numerical status of metabolic/bariatric surgery and its relative distribution of procedures. An email questionnaire was sent to the leadership of the 50 nations or national groupings in the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). Outcome measurements were numbers of metabolic/bariatric operations and surgeons, types of procedures performed, and trends from 2003 to 2008 to 2011 worldwide and in the regional groupings of Europe, USA/Canada, Latin/South America, and Asia/Pacific. Response rate was 84%. The global total number of procedures in 2011 was 340,768; the global total number of metabolic/bariatric surgeons was 6,705. The most commonly performed procedures were Roux-en-Y gastric bypass (RYGB) 46.6%; sleeve gastrectomy (SG) 27.8%; adjustable gastric banding (AGB) 17.8%; and biliopancreatic diversion/duodenal switch (BPD/DS) 2.2%. The global trends from 2003 to 2008 to 2011 showed a decrease in RYGB: 65.1 to 49.0 to 46.6%; an increase, followed by a steep decline, in AGB: 24.4 to 42.3 to 17.8%; and a marked increase in SG: 0.0 to 5.3 to 27.89%. BPD/DS declined: 6.1 to 4.9 to 2.1%. The trends from the four IFSO regions differed, except for the universal increase in SG. Periodic metabolic/bariatric surgery surveys add to the knowledge and understanding of all physicians caring for morbidly obese patients. The salient message of the 2011 assessment is that SG (0.0% in 2008) has markedly increased in prevalence.

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Metabolic/bariatric surgery Worldwide 2008.

Henry Buchwald, Cecilia Øien (2009)

Periodically, the state of bariatric surgery worldwide should be assessed; the most recent prior evaluation was in 2003. An email survey was sent to the leadership of the 36 International Federation for the Surgery of Obesity and Metabolic Disorders nations or national groupings, as well as Denmark, Norway, and Sweden. Responses were tabulated; calculation of relative prevalence of specific procedures was done by weighted averages. Out of a potential 39, 36 nations or national groupings responded. In 2008, 344,221 bariatric surgery operations were performed by 4,680 bariatric surgeons; 220,000 of these operations were performed in USA/Canada by 1,625 surgeons. The most commonly performed procedures were laparoscopic adjustable gastric banding (AGB; 42.3%), laparoscopic standard Roux-Y gastric bypass (RYGB; 39.7%), and total sleeve gastrectomies 4.5%. Over 90% of procedures were performed laparoscopically. Comparing the 5-year trend from 2003 to 2008, all categories of procedures, with the exception of biliopancreatic diversion/duodenal switch, increased in absolute numbers performed. However, the relative percent of all RYGBs decreased from 65.1% to 49.0%; whereas, AGB increased from 24.4% to 42.3%. Markedly, different trends were found for Europe and USA/Canada: in Europe, AGB decreased from 63.7% to 43.2% and RYGB increased from 11.1% to 39.0%; whereas, in USA/Canada, AGB increased from 9.0% to 44.0% and RYGB decreased from 85.0% to 51.0%. The absolute growth rate of bariatric surgery decreased over the past 5 years (135% increase), in comparison to the preceding 5 years (266% increase). Bariatric surgery continues to grow worldwide, but less so than in the past. The types of procedures are in flux; trends in Europe vs USA/Canada are diametrically opposed.

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Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years.

Didier Look, N V Christou, L MacLean (2006)

To complete a long-term (>10 years) follow-up of patients undergoing isolated roux-en-Y gastric bypass for severe obesity. Long-term results of gastric bypass in patients followed for longer than 10 years is not reported in the literature. Accurate weights were recorded on 228 of 272 (83.8%) of patients at a mean of 11.4 years (range, 4.7-14.9 years) after surgery. Results were documented on an individual basis for both long- and short-limb gastric bypass and compared with results at the nadir BMI and % excess weight loss (%EWL) at 5 years and >10 years post surgery. There was a significant (P 50 kg/m) from the nadir to 5 years and from 5 to 10 years. The super obese lost more rapidly from time zero and gained more rapidly after reaching the lowest weight at approximately 2 years than the morbidly obese patients. There was no difference in results between the long- and short-limb operations. There was a significant increase in failures and decrease in excellent results at 10 years when compared with 5 years. The failure rate when all patients are followed for at least 10 years was 20.4% for morbidly obese patients and 34.9% for super obese patients. The gastric bypass limb length does not impact long-term weight loss. Significant weight gain occurs continuously in patients after reaching the nadir weight following gastric bypass. Despite this weight gain, the long-term mortality remains low at 3.1%.