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Is development in bariatric surgery in Germany compatible with international standards? A review of 16 years of data

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Abstract

Bariatric surgery has expanded tremendously internationally over the past decade. In recent years, bariatric surgery has experienced a significant growth in Germany. However, the question arises as to whether this development is in line with international developments or whether there is still room for improvement that could be challenged. 63,990 primary bariatric procedures recorded in the German Bariatric Surgery Registry (GBSR) were analyzed from 2005 to April 2021. The distribution of procedures according to different variants was analyzed and presented. In the last 16 years, 17 different procedures have been performed. The most common surgical procedure was sleeve gastrectomy (SG), followed by Roux-Y gastric bypass (RYGB) (42%). Adjustable gastric banding (AGB) has declined over time, from 23.5% in the first 5 years to 0.2% in recent years. In comparison, omega-loop gastric bypass has increased over the past 5 years (from 0.4% in the first 5 years to 5.9% in the last 5 years). Laparoscopic procedures have accounted for 96.4% of all bariatric surgeries in recent years. The frequency of some procedures has decreased and some bariatric procedures have lost significance. Overall, bariatric surgery in Germany has developed positively compared to the international trend. Nevertheless, there is one area that needs to be optimized: the development of robotic bariatric surgery, which crawls behind in Germany compared to other countries. To establish the technology in bariatric surgery in a timely manner, a balance must be found between cost neutrality and patient-oriented applications.

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Acknowledgements

We thank Mr. Hukauf for his contribution in the statistical analysis of our data.

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Authors and Affiliations

  1. Department of Surgery, Marien Hospital Herne, Ruhr-University of Bochum, Hölkeskampring 40, 44625, Herne, Germany

    Omar Thaher, Jamal Driouch & Torben Glatz

  2. StatConsult Society for Clinical and Health Services Research GmbH, Am Fuchsberg 11, 39112, Magdeburg, Germany

    Martin Hukauf

  3. Department of General, Visceral, Vascular and Transplant Surgery, University Hospital Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany

    Roland S. Croner

  4. Department of General, Abdominal and Pediatric Surgery, Municipal Hospital, Straße des Friedens 122, 07548, Gera, Germany

    Christine Stroh

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Contributions

OT: study concept, verified data, literature review, manuscript writing, and manuscript revision. JD: study concept, verified data, literature review, manuscript writing, and manuscript revision. TG: verified data, literature review, and manuscript writing. MH: preparation of data for statistical analysis, manuscript writing, and approval of statistical results and outcomes. RSC: revised manuscript critically, literature review, and verification of data for revised manuscript. CS: study concept, preparation, and verification of data for statistical analysis, manuscript revision, and final approval of the manuscript. All the authors confirm that they have full access to the study data, contributed to the article, and approved the submitted version.

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Correspondence to Omar Thaher.

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Conflict of interest

Martin Hukauf was employed by StatConsult GmbH (Magdeburg, Germany). Omar Thaher, Jamal Driouch, Torben Glatz, Roland S. Croner, and Christine Stroh declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as potential conflicts of interest.

Ethical approval

No formal consent was obtained for this study. Ethical approval was waived by the local Ethics Committee of Otto-von-Guericke-University Magdeburg in view of the retrospective nature of the study and all the procedures being performed were part of the routine care. All data were gathered and analyzed in accordance with the privacy and ethical standards of the institutional and national research committee and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all the participants included in the study.

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Thaher, O., Driouch, J., Hukauf, M. et al. Is development in bariatric surgery in Germany compatible with international standards? A review of 16 years of data. Updates Surg 74, 1571–1579 (2022). https://doi.org/10.1007/s13304-022-01349-8

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