Obesity surgery: innovation and specialization

Obesity surgery has nearly 70 years of history. But it is in recent decades that the sector has literally exploded: today in Italy about 25,000 bariatric and metabolic surgery operations are performed every year, which put it practically on a par with the entire field of oncological surgery. Continuous technological improvements have certainly helped to push the increase in interventions, which are increasingly safe and effective. But that’s not all: in fact, the recognition of obesity as a health problem and not an aesthetic one also had a preponderant role.

The awareness that those who fight against this disease have the right to help, be it psychological, pharmacological or, where that is not enough, surgical, has in fact contributed to increasing the demand for, and the supply of, interventions. Today – explains Vincenzo Pilone, full professor of General Surgery at the University of Salerno and Treasurer of the Italian Society of Surgery for Obesity and Metabolic Diseases (Sicob) – bariatric operations are performed in almost all of the complex operating units of general surgery in Italy. And where they are not yet done – he assures us – we are gearing up to be able to carry them out. Obesity surgery has rightfully entered the teachings of general surgery specialization schools throughout Italy. And many young surgeons are interested in specializing in this field.

“This year the first edition of a training course that we organized with Sicob in collaboration with Johnson & Johnson was held, and it had an enormous response – recalls Pilone – The course includes theoretical activities and practical insights at centers of excellence from all over Italy. It was a limited number, and they told me that the number of requests that arrived was impressive, so much so that we will probably need to repeat it with more appointments over the course of a year”.

The interest in similar initiatives demonstrates how much bariatric surgery is a constantly evolving and highly specialized field, which requires profound knowledge and constant updating on the part of the surgeon and the team that accompanies him in the operations and in taking care of the patients. However, there are now many centers that offer bariatric operations, and obviously not all of them can guarantee the same levels of quality. For patients, perhaps frightened by the long waiting lists of centers of excellence, and attracted by the promises of one of the many advertisements that can now be found almost everywhere, it means running the risk of ending up in less expert hands than they should .

“The problem is real, so much so that we are trying to work on a solution at the Sicob level”, underlines Pilone. “Patients find everything on the internet, even a lot of misleading advertising. Instead, we would like Italy to experience what happens in countries like Germany, where I can always know how many operations of a certain type a surgeon officially performs. We would like to arrive at a Sicob certification that certifies the experience of every surgeon specializing in obesity surgery, but at the moment we are still a long way off”.

So how can you make sure that you are tackling the bariatric course accompanied by truly expert professionals? Pilone’s advice is to rely on third party and institutional bodies, such as scientific societies. Sicob does not currently provide information on the experience of individual surgeons, it is true, but it has a quality stamp system that certifies the centers with the highest volume of operations, where all the necessary infrastructures are available to welcome and treat obese patients . By relying on a Sicob certified center – Pilone assures – you are sure to find specialized surgeons and to undergo safe operations with the best chance of being effective.