Best practice recommendations for surgical care in weight loss surgery.
OBJECTIVE
To establish evidence-based guidelines for best practices for surgical care in weight loss surgery (WLS).


METHODS
We carried out a systematic search of English-language literature on WLS in MEDLINE and the Cochrane Library. Key words were used to narrow the field for a selective review of abstracts. Data extraction was performed, and evidence categories were assigned according to a grading system based on established evidence-based models.


RESULTS
We assessed types of WLS, recommended guidelines for appropriateness, developed strategies for medical error reduction, established criteria for credentialing of systems and practitioners, and specified research needed for the future.


CONCLUSIONS
Surgeon training, credentialing, and type of surgery performed were identified as key factors in patient safety. Other important issues in the delivery of best practice care included appropriate patient selection; use of a multidisciplinary treatment team; facility staffing, equipment, and administrative support; and early recognition and proper management of complications.
Kelly
John
J
Department of Surgery, University of Massachusetts Medical Center, 67 Belmont Street, Worcester, MA 01545, USA. kellyj@ummhc.org
Tarnoff
Michael
M
Shikora
Scott
S
Thayer
Bruce
B
Jones
Daniel B
DB
Forse
R Amour
RA
Hutter
Matthew M
MM
Fanelli
Robert
R
Lautz
David
D
Buckley
Frederick
F
Munshi
Imtiaz
I
Coe
Nicolas
N
D015904:Biliopancreatic Diversion; D003406:Credentialing; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods; D019317:Evidence-Based Medicine; D015390:Gastric Bypass; D015391:Gastroplasty; D006801:Humans; D016239:MEDLINE; D019300:Medical Errors / Q000517:prevention & control; D009765:Obesity / Q000601:surgery*; D018579:Patient Selection; D011183:Postoperative Complications / Q000517:prevention & control; D012106:Research / Q000639:trends; D015431:Weight Loss