A guideline for bariatric (obesity) surgery was published 30 years ago. During this thirty-year period, our metabolic and bariatric surgery experience has increased. Hundreds of studies have been published. Obesity treatment has become more understandable. During this time, common surgeries have also developed and changed.
Today, most of the bariatric surgeries are sleeve gastrectomy and gastric bypass (RYGB). Medium and long-term results of these surgeries have been published.
Metabolic Bariatric Surgery is preferably performed with minimally invasive surgical approaches.
In 2022, International Federation of Obesity and Metabolic Disorders (IFSO) made a joint statement. In this paper, new surgical criteria are explained.
*Since the surgical criteria published in 1991, the understanding of obesity and metabolic bariatric surgery has increased significantly based on extensive clinical experience and research.
*Long-term results have proven the safety, efficacy and continuity of metabolic and bariatric surgery in the treatment of severe obesity and its co-morbidities clinically. It is recommended for individuals with a mass index over 35 kg/m2.
*Metabolic and bariatric surgery is recommended for patients with a body mass index over 30 kg/m2 and type 2 diabetic patients who do not respond to treatment.
*Body mass index Metabolic bariatric surgery is recommended for individuals who are between 30-35 kg/m2 and who cannot achieve permanent weight loss or improvement in co-morbidities with non-surgical methods.
*There is no upper age limit for metabolic and bariatric surgery. It is recommended for elderly individuals who will benefit from metabolic and bariatric surgery, concomitant diseases and general anesthesia risks.
*Body mass index 120% (class 2 obesity) and major comorbid disease or body mass index 140% (class It is recommended that children/adolescents with obesity) be evaluated by a multidisciplinary expert team.
*Patients who are considered to be at high risk for metabolic and bariatric surgery (body mass index above 60kg/m2 and patients with heart failure) surgery is not contraindicated.
*It is used in the treatment of obese patients who need other special surgeries such as metabolic and bariatric surgery, joint prosthesis, abdominal wall hernia or organ transplantation.
*Consultation with a multidisciplinary team, risk of complications during the operation It can help manage the patient's modifiable risk factors to reduce and improve outcomes. The final decision for surgical decision should be determined by the surgeon.
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