In the last 10 years the growth of the prevalence of obese people worldwide has influenced society as a whole and various sectors of the medical community which are adapting physically to offer necessary comfort to this segment of the population which, in one way or another, has come to influence considerably all aspects of life in society.
In the United States, for example, the number of obese people currently represents about 18%–38% of the population, in France about 12%–15%, in Australia 18%–20%, in Germany about 18%–27%, and in Brazil, about 15%–30%.
The specific characteristics of the disease of obesity and its comorbidities demand that a multidisciplinary team of specialists function in the preoperative preparation as well as in the postoperative phase. Thus, the physical adaptations necessary for the preoperative phase must include all the places where these professionals who are part of the multidisciplinary team do their work. In addition, there must be a well-defined schedule of service, from the moment the patients seek out the endocrinologist to hear his/her opinion regarding surgical treatment, where there was no previous success with clinical, dietary, or medicinal treatments.
Often patients go directly to a surgeon to get information as to whether or not surgery would be indicated for them, what techniques would be most appropriate, what is the surgical risk, what form of surgery would be used (laparoscopy or open surgery), length of time in the hospital and before returning to routine activities, as well as how much weight they will lose after the procedure and in what time frame the weight loss will occur.
This multidisciplinary team must know the fundamental steps of laparoscopic surgery, the risks, costs, and especially the advantages of this procedure as compared to open surgery, such as less postoperative pain, lack of protracted ileus problem, early food and movement recuperation with less incidence of pulmonary complications and embolic thrombosis, less incidence of infection in the abdominal wall and incisional hernias, and a postoperative recuperation that is much faster, thus resulting in an improved quality of life beginning with the immediate postoperative phase.
The qualifications for a surgeon to perform bariatric surgeries follow the norms adopted by the International Federation for the Surgery of Obesity (IFSO) approved in Cancun in 1997.1
“The Cancun IFSO Statement on Bariatric Surgeon Qualifications: 04-10-1997”
This IFSO Statement is made with the intent to guide those surgeons interested in, or engaged in the practice of, bariatric surgery to understand what qualifications are considered acceptable to the international community of bariatric surgeons (IFSO). This is based upon the IFSO's dedication to optimizing the overall safety and long-term effectiveness of bariatric surgical procedures for those patients who qualify for this surgery.
The IFSO acknowledges that an average, formally certified, general surgeon may be technically capable of performing most primary bariatric surgical procedures. However, like ...