You may apply to become an IFSO-EC Accredited Centre of Excellence in Bariatric and Metabolic Surgery provided that both Institution and surgeon(s) meet the following requirements (Code of Practice):
Surgeon's Qualification & Experience
1. Appropriate certification to perform general surgery.
2. Training and experience in gastrointestinal surgery.
3. Successful completion of a training course in bariatric surgery.
4. Testimonials by mentors (proctors) of satisfactory bariatric surgical ability.
5. Careful maintenance of a database of all bariatric cases, including outcomes.
6. Commitment to postoperative life-time follow-up of the patients.
7. Have performed at least 25 bariatric cases per year. (50 cases are required when Adjustable Gastric Banding is most commonly utilized).
8. Be able to perform revisional surgery.
9. Attend bariatric meetings regularly and subscribe to at least one bariatric journal.
10. Perform at least 25 bariatric cases per year including a number of revisional cases among them. (50 cases are required when Adjustable Gastric Banding is most commonly utilized).
11. Be involved in the training and the accreditation of less-experienced bariatric surgeons.
12. Follow-up for at least 75% of the operated patients.
Institutional Requirements
1. Ensure that surgeons performing bariatric surgery have the appropriate certification, training and experience.
2. Provide ancillary services such as specialized nursing care, dietary instruction, counselling and psychological assistance if and when needed.
3. Have readily available consultants in cardiology, pulmonology, psychiatry and rehabilitation with previous experience in treating bariatric surgery patients.
4. Have trained anaesthesiologists with experience in treating bariatric surgery patients.
5. Ensure that a recovery room capable of providing critical care to morbidly obese patients and an intensive care unit with similar capacity are available.
6. Ensure that radiology department facilities can perform emergency chest x-rays with portable machinery, abdominal ultrasonography and upper GI series.
7. Ensure that blood tests can be performed on a 24-hour basis.
8. Ensure that blood bank facilities are available and blood transfusion can be carried out at any time.
9. Have comprehensive and full in-house consultative services required for the care of the bariatric surgical patients, including critical care services.
10. Have the complete line of necessary equipment, instruments, items of furniture, wheel chairs, operating room tables, beds, radiology facilities such as CT scan, lifts and other facilities specially designed and suitable for morbidly and super obese patients.
11. Have a written informed consent process that informs each patient of the surgical procedure, the risk for complications and mortality rate, alternative treatments, the possibility of failure to lose weight and his/her right to refuse treatment.
12. Maintain details of the treatment and outcome of each patient in a digital database.
13. Have experienced interventional radiologists available to take over the non- surgical management of possible anastomotic leaks and strictures.
14. Performs at least 50 bariatric surgical cases per year including revisional cases. The peri-operative care and the surgical procedures have to be standardized for each surgeon.
15. Provides life-time follow-up for the majority and not less than 75% of all bariatric surgical patients. Patients’ data should be available on request by EAC-BS authorities.