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,
JAMA Surgery – American Medical Association
Published: Feb 3, 2018
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