Bariatric surgery practice patterns among pediatric surgeons in the United States.

BACKGROUND: Metabolic and bariatric surgery (MBS) in adolescents has been shown to be safe and effective, but current practice patterns are variable and poorly understood. The aim of this study is to assess current MBS practice patterns among pediatric surgeons in the United States. METHODS: American Pediatric Surgical Association members were surveyed on current bariatric surgery practices. RESULTS: Four hundred and three (40%) surgeons out of a total of 1013 pediatric surgeons responded to the survey. Only 2 respondents had additional training in MBS (0.5%). One hundred thirty-two (32.6%) report that their practice participates in metabolic and bariatric surgery, with 123 (30.4%) having a specific partner specializing in MBS. Most respondents (92%) stated that they believe high volume is associated with better outcomes with regard to MBS. Only 17 (4.2%) surgeons performed a metabolic and bariatric surgery in the last year. All routinely perform sleeve gastrectomy as their primary procedure. Most (82%) perform procedures with an additional surgeon, either another pediatric surgeon (47%) or an adult bariatric surgeon (47%). All pediatric bariatric surgeons responded that they believe high volume led to better outcomes. Adolescent MBS programs most commonly included pediatric nutritionists (94%), pediatric psychologists (94%), clinical nurses (71%), clinical coordinators (59%), pediatric endocrinologists (59%), and exercise physiologists (52%). CONCLUSION: Only 17 (4.2%) respondents had performed a metabolic and bariatric surgery in the past year, and few of those had additional training in MBS. Future work is necessary to better understand optimal practice patterns for adolescent metabolic and bariatric surgery. TYPE OF STUDY: Review article. LEVEL OF EVIDENCE: Level III.