Original article
American Society for Metabolic and Bariatric Surgery estimation of metabolic and bariatric procedures performed in the United States in 2016

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Abstract

Background

Bariatric surgery, despite being the most successful long-lasting treatment for morbid obesity, remains underused as only approximately 1% of all patients who qualify for surgery actually undergo surgery. To determine if patients in need are receiving appropriate therapy, the American Society for Metabolic and Bariatric Surgery created a Numbers Taskforce to specify annual rate of use for obesity treatment interventions.

Objectives

The objective of this study was to determine metabolic and bariatric procedure trends since 2011 and to provide the best estimate of the number of procedures performed in the United States in 2016.

Setting

United States.

Methods

We reviewed data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, National Surgical Quality Improvement Program, Bariatric Outcomes Longitudinal Database, and Nationwide Inpatient Sample. In addition, data from industry and outpatient centers were used to estimate outpatient center activity. Data from 2016 were compared with the previous 5 years of data.

Results

Compared with 2015, the total number of metabolic and bariatric procedures performed in 2016 increased from approximately 196,000 to 216,000. The sleeve gastrectomy trend is increasing, and it continues to be the most common procedure. The gastric bypass and gastric band trends continued to decrease as seen in previous years. The percentage of revision procedures and biliopancreatic diversion with duodenal switch procedures increased slightly. Finally, intragastric balloons placement emerged as a significant contributor to the cumulative total number of procedures performed.

Conclusions

There is increasing use of metabolic and bariatric procedures performed in the United States from 2011 to 2016, with a nearly 10% increase noted from 2015 to 2016.

Section snippets

Methods

A comprehensive review of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database was completed, which included 100% of the primary and revisional metabolic and bariatric procedures performed within metabolic and bariatric surgery centers that are accredited by MBSAQIP.

In addition, a comprehensive review of the National Surgical Quality Improvement Program (NSQIP) database was also performed, which included 100% of the primary and revisional

Results

Compared with 2015, the total number of bariatric procedures performed in 2016 increased from approximately 196,000 to 216,000. The overall estimated number of metabolic and bariatric procedures for 2016, as well as the trend and percentage breakdown from 2011 to 2016, is listed in Fig 1 and Table 1, Table 2 [3], [4].

The sleeve gastrectomy continues to be the most common procedure, comprising 58.1% of all procedures in 2016. An 18.8% increase was noted from 2015 (105,448 to 125,318), but even

Discussion

This paper represents the best estimate of metabolic and bariatric procedures performed in the United States. Trends over time demonstrate a significant increase in usage of procedures, with a decided uptake in 2016. The determinants of this increase are likely multifactorial, including specialty society outreach, such as the ASMBS National Collaborative Care Summit, influential papers citing level 1 evidence, and raising awareness through media [5], [6], [7]. Of note, patients and referring

Conclusions

There has been a 9.6% increase in the number of metabolic and bariatric procedures performed in 2016 compared with 2015, with an overall increase of 36.5% since 2011. The sleeve gastrectomy continues to be the most common procedure performed in the United States. The number of gastric banding procedures performed annually continues to decline precipitously, as do the number of gastric bypass procedures. Revisional bariatric procedures continue to increase, comprising approximately 1 of every 7

Disclosures

The authors have no commercial or financial interests that would pertain to the content of the article.

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