Publications by authors named "Jaime Ponce"
The 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) updated the indications for metabolic and bariatric surgery (MBS), replacing the previous guidelines established by the National Institutes of Health (NIH) over 30 years ago. The evidence supporting these updated guidelines has been strengthened to assist metabolic and bariatric surgeons, nutritionists, and other members of multidisciplinary teams (MDTs), as well as patients. This study aims to assess the level of evidence and the strength of recommendations compared to the previously published criteria.
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- The ASMBS and IFSO updated the guidelines for Metabolic and Bariatric Surgery in 2022, replacing 30-year-old NIH recommendations.
- These new guidelines are based on stronger evidence and are designed to support healthcare professionals and patients in making informed decisions about surgery.
- The study evaluates the quality of evidence and the effectiveness of these updated recommendations compared to the old criteria.
Article Synopsis
- The study highlights the increasing importance of metabolic and bariatric surgery (MBS) in addressing global obesity, emphasizing the need for rigorous academic and fellowship training for surgeons.
- A Modified Delphi method involving 89 surgeons from 42 countries was used to establish expert consensus on the necessary criteria for surgeons to obtain privileges for performing MBS, reaching agreement on 29 out of 30 statements.
- Key consensus points include the requirement for surgeons to hold a general surgery degree, complete a dedicated fellowship, and adhere to defined learning curves for various MBS procedures, alongside maintaining patient data and collaborating in a multidisciplinary team.
Background: With the implementation of the 11th edition of the International Classification of Diseases (ICD-11) and the publication of the metabolic dysfunction-associated fatty liver disease (MAFLD) nomenclature in 2020, it is important to establish consensus for the coding of MAFLD in ICD-11. This will inform subsequent revisions of ICD-11.
Methods: Using the Qualtrics XM and WJX platforms, questionnaires were sent online to MAFLD-ICD-11 coding collaborators, authors of papers, and relevant association members.
Background: Metabolic and bariatric surgery (MBS), despite being the most effective durable treatment for obesity, remains underused as approximately 1% of all qualified patients undergo surgery. The American Society for Metabolic and Bariatric Surgery established a Numbers Taskforce to specify the annual rate of obesity treatment interventions utilization and to determine if patients in need are receiving appropriate treatment.
Objective: To provide the best estimated number of metabolic and bariatric procedures being performed in the United States in 2022.
Article Synopsis
- * A study using a consensus method involved 78 bariatric surgeons globally, who agreed on 54 statements regarding when to use MBS for Class I and II obesity, determining a 70% agreement threshold.
- * The experts concluded that MBS is cost-effective for Class II obesity and Class I obesity with inadequate weight loss from non-surgical methods, and identified specific surgical options including intra-gastric balloon, endoscopic sleeve gastroplasty, sleeve gastrectomy, Roux-en-Y gastric bypass, and one
Background: Metabolic and bariatric surgery (MBS) is the preferred method to achieve significant weight loss in patients with Obesity Class V (BMI > 60 kg/m). However, there is no consensus regarding the best procedure(s) for this population. Additionally, these patients will likely have a higher risk of complications and mortality.
View Article and Find Full Text PDFBackground: The American Society of Metabolic and Bariatric Surgeons (ASMBS) Leadership Academy is conducted at the ASMBS Weekend to prepare surgeons for practice, while in their fellowship.
Objectives: The aim of this analysis is to gather the views of current fellows in training on issues regarding practice patterns and career development.
Setting: Survey at ASMBS Fellows Leadership Academy.
Background: Although the sleeve gastrectomy (SG) is the dominant bariatric procedure, studies have shown conversion rates of up to 30%. These conversions are generally for weight regain (WR), insufficient weight loss (IWL) or gastroesophageal reflux disease (GERD). Before 2020, details on why conversions were being performed were not collected in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Participant Use Data File (PUF).
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- Laparoscopic BariClip gastroplasty (LBCG) is a new, reversible weight-loss procedure, but it can lead to complications such as slippage, which the study aims to classify and analyze.
- A review of 381 LBCG patients revealed a 4.46% incidence of slippage, with symptoms mostly involving vomiting and nausea, and a new classification based on the timing and type of slippage was proposed.
- The management of slippage cases included removal of the BariClip, repositioning, or conservative treatment, with various displacement types identified via radiological studies.
Introduction: Laparoscopic BariClip gastroplasty (LBCG) will address a similar tubular restriction than the one achieved with the laparoscopic sleeve gastrectomy (LSG) at the level of the gastric fundus, while maintaining the advantage of simplicity and anatomic preservation. The purpose of the current study was to analyze the risk of slippage and to present the evolving technique by adding gastro-gastric plication of the gastric wall covering the BariClip at those areas where the gastric wall "slips" between the limbs of the clip.
Methods: All patients undergoing LBCG with the evolving technique of gastric plication around the device associated with antral gastroplasty from January 2021 to May 2022 were included in the study group (group A).
Introduction/purpose: One anastomosis gastric bypass (OAGB) and single anastomosis duodenoileostomy with sleeve (SADI-S) are two highly effective bariatric procedures that have been recently endorsed by the American Society of Metabolic and Bariatric Surgery (ASMBS). We compared the outcomes and safety profiles of SADI-S and OAGB using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database.
Materials And Methods: Retrospective analysis on patients who underwent SADI-S or OAGB obtained from the MBSAQIP database 2020-2021.
MAJOR UPDATES TO 1991 NATIONAL INSTITUTES OF HEALTH GUIDELINES FOR BARIATRIC SURGERY: Metabolic and bariatric surgery (MBS) is recommended for individuals with a body mass index (BMI) >35 kg/m, regardless of presence, absence, or severity of co-morbidities.MBS should be considered for individuals with metabolic disease and BMI of 30-34.9 kg/m.
View Article and Find Full Text PDFMajor updates to 1991 National Institutes of Health guidelines for bariatric surgery.
View Article and Find Full Text PDFBackground: Metabolic and bariatric surgery (MBS), despite being the only effective durable treatment for obesity, remains underused as approximately 1% of all patients who qualify undergo surgery. The American Society for Metabolic and Bariatric Surgery created a Numbers Taskforce to specify annual rate of utilization for obesity treatment interventions and to determine if patients in need are receiving appropriate treatment.
Objective: The objective of this study was to provide the best estimated number of metabolic and bariatric procedures performed in the United States in 2020.
Article Synopsis
- Bariatric surgery has shown long-term quality improvements, but malpractice claims provide insights into areas needing enhancement.
- A study analyzed closed malpractice claims from a national registry involving 175 cases between 2006-2014, focusing on causes and potential preventability of complications.
- Key issues leading to claims included mortality and leaks, with identified areas for improvement being better diagnosis, timely treatment, postoperative care, and communication.
Background: The long-term safety results of the REALIZE (Ethicon Endo-Surgery, Inc., Cincinnati, OH) adjustable gastric band collected in this prospective, multicenter study in patients with morbid obesity are presented.
Objectives: To determine the reoperation rate, including band revisions, replacements, and explants, resulting from a serious adverse device-related event through years 4 and 5.
Background: Cell-free DNA (cfDNA) is used in clinical research to identify biomarkers for diagnosis of and follow-up on cancer. Here, we propose a fast and innovative approach using traditional housekeeping genes as cfDNA targets in a copy number analysis. We focus on the application of highly sensitive technology such as digital PCR (dPCR) to differentiate breast cancer (BC) patients and controls by quantifying regions of PUM1 and RPPH1 (RNase P) in plasma samples.
View Article and Find Full Text PDFIntroduction: Sleeve gastrectomy (SG) is the commonest bariatric procedure worldwide. Yet there is significant variation in practice concerning its various aspects. This paper report results from the first modified Delphi consensus-building exercise on SG.
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- The study aimed to gather a consensus among 44 expert bariatric surgeons on how to safely resume Bariatric and Metabolic Surgery during the COVID-19 pandemic.
- A modified Delphi method was used, allowing the experts to review and agree on 111 proposed statements across two rounds, with a consensus defined as at least 70% agreement.
- The results include 38 key recommendations that can help medical teams resume surgeries and guide future research in the field.
A Review of the Role of Robotics in Bariatric Surgery: Finding Our Future?
J Laparoendosc Adv Surg Tech A
January 2020
Obesity rates continue to rise in America and around the World. Numerous studies show the benefit of bariatric surgery on all-cause mortality in obese patients. Given its substantial role in the future of patient care, we continue to search for the most beneficial ways to optimize patient outcomes and procedural costs in bariatric surgery.
View Article and Find Full Text PDFBackground: Obesity is a significant health problem and additional therapies are needed to improve obesity treatment.
Objective: Determine the efficacy and safety of a 6-month swallowable gas-filled intragastric balloon system for weight loss.
Setting: Fifteen academic and private practice centers in the United States.
Background: Bariatric surgical procedures are an effective and enduring treatment for severe obesity. In addition to improvements in health status, bariatric operations have been noted to potentially decrease postoperative healthcare costs, particularly medication use.
Study Design: We performed a longitudinal analysis of 2007-2012 claims data comparing a bariatric surgical cohort with a propensity-matched nonsurgical control group during a 5-year time period.
Aim: To evaluate the prognostic value of tumor-infiltrating lymphocytes (TILs) and Ki67 in brain metastasis lesions, and the effect of adding them to variables of graded prognostic assessment score.
Patients & Methods: Clinicopathological information from 111 medical charts of brain metastasis patients was obtained, and TIL distribution (n = 84), Ki67 index (n = 79) and CD3 TIL (n = 64) were prospectively evaluated.
Results: Most frequent TIL pattern was perivascular (67.