Background and Aim
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.
The 2016 IFSO Survey form was emailed to all IFSO societies. Each Society was requested to indicate the number and type of bariatric procedures performed in the country. Trend analyses from 2008 to 2016 were also performed.
The total number of bariatric/metabolic procedures performed in 2016 was 685,874; 634,897 (92.6%) of which were primary and 50,977 were revisional (7.4%). Among the primary interventions, 609,897 (96%) were surgical and 25,359 (4%) were endoluminal. The most performed primary surgical bariatric/metabolic procedure was sleeve gastrectomy (SG) (N = 340,550; 53.6%), followed by Roux-en-Y gastric bypass (N = 191,326; 30.1%), and one-anastomosis gastric bypass (N = 30,563; 4.8%).
In 2016, there was an increase in the total number both of surgical and endoluminal bariatric/metabolic procedures. Revisional procedures represent about 7% of the total bariatric interventions. SG remains the most performed surgical procedure in the world.
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Colquitt JL, Pickett K, Loveman E, Frampton GK. Surgery for weight loss in adults. Cochrane Database Syst Rev 2014(8): CD003641. https://doi.org/10.1002/14651858.CD003641.pub4
Lee PC, Dixon J. Medical devices for the treatment of obesity. Nat Rev Gastroenterol Hepatol. 2017;14(9):553–64. https://doi.org/10.1038/nrgastro.2017.80.
Favretti F, Cadiere GB, Segato G, et al. Laparoscopic placement of adjustable silicone gastric banding: early experience. Obes Surg. 1995;5(1):71–3.
Favretti F, Cadiere GB, Segato G, et al. Laparoscopic adjustable silicone gastric banding: technique and results. Obes Surg. 1995;5(4):364–71.
Himpens J, Cadiere GB, Bazi M, et al. Long-term outcomes of laparoscopic adjustable gastric banding. Arch Surg (Chicago, Ill : 1960). 2011;146(7):802–7. https://doi.org/10.1001/archsurg.2011.45.
Suter M, Calmes JM, Paroz A, et al. A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates. Obes Surg. 2006;16(7):829–35. https://doi.org/10.1381/096089206777822359.
Bueter M, Thalheimer A, Wierlemann A, et al. Reoperations after gastric banding: replacement or alternative procedures? Surg Endosc. 2009;23(2):334–40. https://doi.org/10.1007/s00464-008-9926-8.
Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2008. Obes Surg. 2009;19(12):1605–11. https://doi.org/10.1007/s11695-009-0014-5.
Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obes Surg. 1998;8(3):267–82. https://doi.org/10.1381/096089298765554476.
Ren CJ, Patterson E, Gagner M. Early results of laparoscopic biliopancreatic diversion with duodenal switch: a case series of 40 consecutive patients. Obes Surg. 2000;10(6):514–23; discussion 524. https://doi.org/10.1381/096089200321593715.
Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13(6):861–4. https://doi.org/10.1381/096089203322618669.
Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20(6):859–63. https://doi.org/10.1007/s00464-005-0134-5.
Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17(7):962–9.
Deitel M, Crosby RD, Gagner M. The first international consensus summit for sleeve gastrectomy (SG), New York City, October 25-27, 2007. Obes Surg. 2008;18(5):487–96. https://doi.org/10.1007/s11695-008-9471-5.
Updated position statement on sleeve gastrectomy as a bariatric procedure. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 2010;6(1):1–5. https://doi.org/10.1016/j.soard.2009.11.004.
Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery and endoluminal procedures: IFSO worldwide survey 2014. Obes Surg. 2017;27:2279–89. https://doi.org/10.1007/s11695-017-2666-x.
Angrisani L. 2014: the year of the sleeve supremacy. Obes Surg. 2017;27(6):1626–7. https://doi.org/10.1007/s11695-017-2681-y.
Jammu GS, Sharma R. A 7-year clinical audit of 1107 cases comparing sleeve gastrectomy, Roux-En-Y gastric bypass, and mini-gastric bypass, to determine an effective and safe bariatric and metabolic procedure. Obes Surg. 2016;26(5):926–32. https://doi.org/10.1007/s11695-015-1869-2.
Felsenreich DM, Langer FB, Kefurt R, et al. Weight loss, weight regain, and conversions to Roux-en-Y gastric bypass: 10-year results of laparoscopic sleeve gastrectomy. Surg Obes Relat Dis : official journal of the American Society for Bariatric Surgery. 2016;12(9):1655–62. https://doi.org/10.1016/j.soard.2016.02.021.
Arman GA, Himpens J, Dhaenens J, et al. Long-term (11+years) outcomes in weight, patient satisfaction, comorbidities, and gastroesophageal reflux treatment after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis : official journal of the American Society for Bariatric Surgery. 2016;12(10):1778–86. https://doi.org/10.1016/j.soard.2016.01.013.
Mason EE, Ito C. Gastric bypass in obesity. Surg Clin North Am. 1967;47(6):1345–51.
Wittgrove AC, Clark GW, Tremblay LJ. Laparoscopic gastric bypass, Roux-en-Y: preliminary report of five cases. Obes Surg. 1994;4(4):353–7. https://doi.org/10.1381/096089294765558331.
Christou NV, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244(5):734–40. https://doi.org/10.1097/01.sla.0000217592.04061.d5.
De Luca M, Tie T, Ooi G, et al. Mini gastric bypass-one anastomosis gastric bypass (MGB-OAGB)-IFSO position statement. Obes Surg. 2018;28:1188–206. https://doi.org/10.1007/s11695-018-3182-3.
Fisher BL, Buchwald H, Clark W, et al. Mini-gastric bypass controversy. Obes Surg. 2001;11(6):773–7.
Lee WJ, Lin YH. Single-anastomosis gastric bypass (SAGB): appraisal of clinical evidence. Obes Surg. 2014;24(10):1749–56. https://doi.org/10.1007/s11695-014-1369-9.
Scozzari G, Trapani R, Toppino M, et al. Esophagogastric cancer after bariatric surgery: systematic review of the literature. Surg Obes Relat Dis : official journal of the American Society for Bariatric Surgery. 2013;9(1):133–42. https://doi.org/10.1016/j.soard.2012.10.002.
Bruzzi M, Rau C, Voron T, et al. Single anastomosis or mini-gastric bypass: long-term results and quality of life after a 5-year follow-up. Surg Obes Relat Dis : official journal of the American Society for Bariatric Surgery. 2015;11(2):321–6. https://doi.org/10.1016/j.soard.2014.09.004.
Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25(10):1822–32. https://doi.org/10.1007/s11695-015-1657-z.
Alkhalifah N, Lee WJ, Hai TC, et al. 15-year experience of laparoscopic single anastomosis (mini-) gastric bypass: comparison with other bariatric procedures. Surg Endosc. 2018;32:3024–31. https://doi.org/10.1007/s00464-017-6011-1.
Scopinaro N, Gianetta E, Civalleri D, et al. Bilio-pancreatic bypass for obesity: II. Initial experience in man. Br J Surg. 1979;66(9):618–20.
Marceau P, Hould FS, Simard S, et al. Biliopancreatic diversion with duodenal switch. World J Surg. 1998;22(9):947–54.
Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013;23(4):427–36. https://doi.org/10.1007/s11695-012-0864-0.
Gagner M, Matteotti R. Laparoscopic biliopancreatic diversion with duodenal switch. Surg Clin North Am. 2005;85(1):141–9, x-xi. https://doi.org/10.1016/j.suc.2004.10.003.
Roslin MS, Gagner M, Goriparthi R, et al. The rationale for a duodenal switch as the primary surgical treatment of advanced type 2 diabetes mellitus and metabolic disease. Surg Obes Relat Dis : official journal of the American Society for Bariatric Surgery. 2015;11(3):704–10. https://doi.org/10.1016/j.soard.2014.11.017.
Skogar ML, Sundbom M. Duodenal switch is superior to gastric bypass in patients with super obesity when evaluated with the bariatric analysis and reporting outcome system (BAROS). Obes Surg. 2017;27(9):2308–16. https://doi.org/10.1007/s11695-017-2680-z.
Sanchez-Pernaute A, Rubio Herrera MA, Perez-Aguirre E, et al. Proximal duodenal-ileal end-to-side bypass with sleeve gastrectomy: proposed technique. Obes Surg. 2007;17(12):1614–8. https://doi.org/10.1007/s11695-007-9287-8.
Sanchez-Pernaute A, Rubio MA, Perez Aguirre E, et al. Single-anastomosis duodenoileal bypass with sleeve gastrectomy: metabolic improvement and weight loss in first 100 patients. Surg Obes Relat Dis : official journal of the American Society for Bariatric Surgery. 2013;9(5):731–5. https://doi.org/10.1016/j.soard.2012.07.018.
Mahdy T, Al Wahedi A, Schou C. Efficacy of single anastomosis sleeve ileal (SASI) bypass for type-2 diabetic morbid obese patients: gastric bipartition, a novel metabolic surgery procedure: a retrospective cohort study. Int J Surg (London, England). 2016;34:28–34. https://doi.org/10.1016/j.ijsu.2016.08.018.
Machytka E, Gaur S, Chuttani R, et al. Elipse, the first procedureless gastric balloon for weight loss: a prospective, observational, open-label, multicenter study. Endoscopy. 2017;49(2):154–60. https://doi.org/10.1055/s-0042-119296.
Angrisani L, Santonicola A, Vitiello A, et al. Elipse balloon: the pitfalls of excessive simplicity. Obes Surg. 2018;28:1419–21. https://doi.org/10.1007/s11695-018-3148-5.
Scopinaro N. The IFSO and obesity surgery throughout the world. International Federation for the Surgery of obesity. Obes Surg. 1998;8(1):3–8.
Buchwald H, Williams SE. Bariatric surgery worldwide 2003. Obes Surg. 2004;14(9):1157–64. https://doi.org/10.1381/0960892042387057.
We thank the Presidents of the responding IFSO national societies and Manuela Mazzarella and Stefanie D’arco of IFSO Secretariat for their support.
IFSO Nation President
Argentina Mario Antozzi
Australia–New Zeland Ahmad Aly
Austria Gerhard Prager
Azerbaijan Taryel Omerov
Belgium Jean Saey
Bolivia Sergio Aparicio
Brazil Caetano Marchesini
Canada* Laurent Biertho
Chile Ricardo Funke
China Cunchuan Wuang
Colombia Cesar Guevara
Costa Rica Jorge Esmeral
Czech Republic Martin Fried
Dominican Republic Luis Betances
Ecuador Max Torres
Egypt Alaa Abbas
Finland Jyrki Kössi
France Jerome Dargent
Germany Dieter Birk
Greece Dimitrios Zacharoulis
Guatemala Fernando Montufar
Honduras Ricardo Pena
Hong Kong Simon Wong
Iceland Audun Sigurdsson
India Rajesh Khullar
Iran Kalaji Alireza
Israel Nasser Sakran
Italy Luigi Piazza
Japan Hisahiro Matsubara
Jordan Ahmad Sami Salem
Kazakhstan Oral Ospanov
Korea Joo-Ho Lee
Kuwait Mohammed Al Jarallah
Lebanon Jean Biagini
Lithuania Almantas Maleckas
Malaysia Hisham Mura Nor
México Nelson Rodriguez Huerta
Netherlands Bart van Wagensveld
Norway Marius Svanevik
Perú Ramiro Carbajal Nicho
Poland Mariusz Wylezol
Portugal Jorge Santos
Romania Niculae Iordache
Russian Federation Yury Yashkov
Saudi Arabia Khalid Mirza Gari
Singapore Asim Shabbir
Slovenia Tadeja Pintar
South Africa Tess van der Merwe
Spain Juan Carlos Ruiz da Adana
Sweden Torsten Olbers
Switzerland Renward S. Hauser
Taiwan Wei-Jei Lee
Turkey Mustafa Taskin
Ukraine Andriy Lavryk
UAE Ali Khammas
UK Roger Ackroyd
USA Stacy Brethauer
Venezuela Salvador Navarrete
Conflict of Interest
The authors declare that they have no conflicts of interest.
Statement of Informed Consent
This is a survey in which we do not directly involve human subjects; it is limited to an analysis of bariatric procedures performed around the world.
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Angrisani, L., Santonicola, A., Iovino, P. et al. IFSO Worldwide Survey 2016: Primary, Endoluminal, and Revisional Procedures. OBES SURG 28, 3783–3794 (2018). https://doi.org/10.1007/s11695-018-3450-2
- Bariatric metabolic surgery
- Worldwide survey
- Endoluminal and revisional procedures