This IFSO Statement is made with the intent to guide those surgeons interested in, or engaged in the practice of, bariatric surgery to understand what qualifications are considered acceptable to the international community of bariatric surgeons (IFSO). This is based upon the IFSO’s dedication to optimizing the overall safety and long-term effectiveness of bariatric surgical procedures for those patients who qualify for this surgery.
The IFSO acknowledges that an average, formally certified, general surgeon may be technically capable of performing most primary bariatric surgical procedures. However, like any other area of surgery, the techniques which improve each surgical procedure’s safety and effectiveness are exemplified by experienced and frequent practitioners of each particular type of bariatric surgery.
The IFSO also acknowledges that the proper patient selection and education as well as short-, intermediate- and long-term management of primary bariatric surgery patients is extremely complex. This requires considerable experience and judgement which should best be learned from a preceptor(s) with in-depth experience in bariatric surgery.
IFSO, therefore, strongly recommends that, prior to independently performing primary bariatric surgery, each surgeon meet the following minimal standards:
- Be a fully-trained, qualified, certified general or gastrointestinal surgeon who has completed a recognized general/gastrointestinal surgery program;
- Has completed a preceptorship in all aspects of bariatric surgery, including patient education, support groups, operative techniques and post-operative follow-up with an IFSO or IFSO Affiliate Society-designated bariatric surgeon or one who has performed at least 200 bariatric surgical procedures and has five or more years experience in the field of bariatric surgery;
- Has received a written approval from his preceptor of his/her satisfactory bariatric surgical abilities;
- Maintains a well-informed, up-to-date knowledge of bariatrics and bariatric surgery literature such as contained in the journal Obesity Surgery;
- Holds, or has applied for, membership in an Adhering Body of IFSO or, if no such national body is available to him or her, to IFSO directly;
- Has attended at least one meeting of IFSO or one of its Adhering Bodies or one of its bariatric surgery courses;
- Is personally committed to strongly encouraging the necessary education and life-long follow-up of his/her bariatric surgery patients;
- Performs bariatric surgery in institutions where he/she has made every reasonable effort to obtain equipment, facilities and support systems adequate for the comfort and safety of bariatric surgery patients.
IFSO also acknowedges that re-operative bariatric surgery is an even more complex and demanding area which requires considerable primary bariatric surgical experience, as well as knowledge of surgical options, precautions, risks, benefits, possible complications and implications. This requires considerable experience and judgement which should best be learned from one or more colleagues with in-depth experience of re-operative bariatric surgery. It therefore recommends that the bariatric surgeon, at least early in his/her re-operative bariatric surgical practice, refer back to, confer with or otherwise work with, one or more bariatric surgical colleagues who have extensive experience in re-operative bariatric surgery, ideally 60 or more such cases.