Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Accreditation—Reply

Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Accreditation—Reply Letters tion criteria with the aim of finding those patients most likely quality. More than 70% of centers were not located in the same to succeed without a reoperation. By and large, none of these service area as a higher-performing center. approaches were widely implemented with the adjustable gas- We also have concerns about the authors’ new definition tric band. As a result, the device was adopted with variable ef- of serious complications that was used to suggest quality quin- fectiveness, and subsequently, most bariatric surgeons moved tiles. Using the American College of Surgeons risk calculator away from the procedure. and assuming the lowest-risk patient with a body mass index The future of the adjustable gastric band is likely limited of 40, the serious complication risk is greater for both laparo- 4,5 to a subset of patients at best. That said, it provides us many scopic cholecystectomy (2.1%) and laparoscopic colectomy lessons to improve how we adopt and monitor new devices and (8%) than for bariatric surgery (1.8%) in this study. In fact, the procedures in surgery. 8% serious complication rate for laparoscopic colectomy fell within the confidence intervals for every bariatric center in the Andrew M. Ibrahim, MD, http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Surgery American Medical Association

Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Accreditation—Reply

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Publisher
American Medical Association
Copyright
Copyright 2018 American Medical Association. All Rights Reserved.
ISSN
2168-6254
eISSN
2168-6262
D.O.I.
10.1001/jamasurg.2017.4590
Publisher site
See Article on Publisher Site

Abstract

Letters tion criteria with the aim of finding those patients most likely quality. More than 70% of centers were not located in the same to succeed without a reoperation. By and large, none of these service area as a higher-performing center. approaches were widely implemented with the adjustable gas- We also have concerns about the authors’ new definition tric band. As a result, the device was adopted with variable ef- of serious complications that was used to suggest quality quin- fectiveness, and subsequently, most bariatric surgeons moved tiles. Using the American College of Surgeons risk calculator away from the procedure. and assuming the lowest-risk patient with a body mass index The future of the adjustable gastric band is likely limited of 40, the serious complication risk is greater for both laparo- 4,5 to a subset of patients at best. That said, it provides us many scopic cholecystectomy (2.1%) and laparoscopic colectomy lessons to improve how we adopt and monitor new devices and (8%) than for bariatric surgery (1.8%) in this study. In fact, the procedures in surgery. 8% serious complication rate for laparoscopic colectomy fell within the confidence intervals for every bariatric center in the Andrew M. Ibrahim, MD,

Journal

JAMA SurgeryAmerican Medical Association

Published: Feb 3, 2018

References

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