Evolution of Bariatric Quality Initiatives

  • Eric J. DeMaria


Quality improvement characterizes bariatric surgery throughout its brief history. In this chapter we will review early quality initiatives focusing on data collection via registries such as the International Bariatric Surgery Registry and BAROS. Subsequent evolutions in the study of quality include the professional society efforts such as the ASMBS/Surgical Review Bariatric Surgery Centers of Excellence program but also other smaller regional initiatives such as the Betsy Lehman initiative and the Michigan Bariatric Surgery Collaborative. Finally we will overview the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) developed through the combined efforts of ASMBS and the American College of Surgeons.


Quality improvement Data collection registry Bariatric surgery National data BOLD MBSAQIP IBSR BAROS Michigan Bariatric Surgery Collaborative Betsy Lehman Center 


  1. 1.
    Mason EE, Tang S, Renquist KE, Barnes DT, Cullen JJ, Doherty C, Maher JW. A decade of change in obesity surgery. National Bariatric Surgery Registry (NBSR) Contributors. Obes Surg. 1997;7(3):189–97.CrossRefGoogle Scholar
  2. 2.
    Mason EE, Renquist KE, Jiang D. Perioperative risks and safety of surgery for severe obesity. Am J Clin Nutr. 1992;55(2):573S–6S.CrossRefGoogle Scholar
  3. 3.
    Zhang W, Mason EE, Renquist KE, et al. Factors influencing survival following surgical treatment of obesity. Obes Surg. 2005;15(1):43–50.CrossRefGoogle Scholar
  4. 4.
    Mason EE, Renquist KE, Huang YH, Jamal M, Samuel I. Causes of 30-day bariatric surgery mortality: with emphasis on bypass obstruction. Obes Surg. 2007;17(1):9–14.CrossRefGoogle Scholar
  5. 5.
    National Institutes of Health Consensus Development Panel. Gastrointestinal surgery for severe obesity: National Institutes of Health Consensus Development Conference Statement. Ann Intern Med. 1991;115:956–61.CrossRefGoogle Scholar
  6. 6.
    Pories WJ, Flickinger EC, Meelheim D, et al. The effectiveness of gastric bypass over gastric partition in morbid obesity. Ann Surg. 1982;196:389–99.CrossRefGoogle Scholar
  7. 7.
    Freeman JB, Burchett H. Failure rate with gastric partitioning for morbid obesity. Am J Surg. 1983;145:113–9.CrossRefGoogle Scholar
  8. 8.
    Halverson JD, Zuckerman GR, Koehler RE, et al. Gastric bypass for morbid obesity: a medical-surgical assessment. Ann Surg. 1981;194:152–60.CrossRefGoogle Scholar
  9. 9.
    Mason EE, Maher JW, Scott DH, et al. Ten years of vertical banded gastroplasty for severe obesity. Probl Gen Surg. 1992;9:280–9.Google Scholar
  10. 10.
    Reinhold RB. Critical analysis of long-term weight loss following gastric bypass. Surg Gynecol Obstet. 1982;155:385–94.PubMedGoogle Scholar
  11. 11.
    Brolin RE, Kasnetz KA, Greefield DP, et al. A new classification system for weight loss analysis after bariatric operations. Clin Nutr. 1986;5:5–8.Google Scholar
  12. 12.
    Sullivan MBE, Sullivan LGM, Kral KG. Quality of life assessment in obesity: physical, psychological, and social function. Gastroenterol Clin N Am. 1987;16:33–42.Google Scholar
  13. 13.
    Ware JE, Sherbourne CD. The MOS short-form survey (SF-36) (I: conceptual framework and item selection). Med Care. 1992;30:473–83.CrossRefGoogle Scholar
  14. 14.
    Velanovich V. Comparison of generic (SF-36) vs. disease-specific (GERD-HRQL) quality-of-life scales for gastroesophageal reflux disease. J Gastrointest Surg. 1998;2:141–5.CrossRefGoogle Scholar
  15. 15.
    Oria HE. Reporting results in obesity surgery: evaluation of a limited survey. Obes Surg. 1996;6:361–8.CrossRefGoogle Scholar
  16. 16.
    Oria HE, Moorehead MK. Bariatric analysis and reporting outcome system (BAROS). Obes Surg. 1998;8:487–99.CrossRefGoogle Scholar
  17. 17.
    Favretti F, Cadiere GB, Segato G, et al. Bariatric analysis and reporting outcome system (BAROS). Obes Surg. 1998;8:500–4.CrossRefGoogle Scholar
  18. 18.
    Nguyen NT, Goldman C, Rosenquist CT, et al. Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs. Ann Surg. 2001;11:265–70.Google Scholar
  19. 19.
    Victorzon M, Tolonen P. Bariatric Analysis and Reporting Outcome System (BAROS) following laparoscopic adjustable gastric banding in Finland. Obes Surg. 2001;11:740–3.CrossRefGoogle Scholar
  20. 20.
    Nini E, Slim K, Scesa JL, et al. Evaluation of laparoscopic bariatric surgery using the BAROS score. Ann Chir. 2002;127:107–14.CrossRefGoogle Scholar
  21. 21.
    Titi M, Jenkins JT, Modak P, et al. Quality of life and alteration in comorbidity following adjustable gastric banding. Postgrad Med J. 2007;83:487–91.CrossRefGoogle Scholar
  22. 22.
    Pratt GM, McLees B, Pories WJ. The ASBS Bariatric Surgery Centers of Excellence program: a blueprint for quality improvement. Surg Obes Relat Dis. 2006;2(5):497–503. discussion 503CrossRefGoogle Scholar
  23. 23.
    Lehman Center Weight Loss Surgery Expert Panel. Commonwealth of Massachusetts Betsy Lehman Center for patient safety and medical error reduction expert panel on weight loss surgery: executive report. Obes Res. 2005;13(2):205–26.CrossRefGoogle Scholar
  24. 24.
    Michigan Bariatric Surgery Collaborative (MBSC). [Internet]. [Cited 2019 Feb 13]. Available from:
  25. 25.
    Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. [Internet]. [Cited 2019 Feb 13]. Available from:

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Eric J. DeMaria
    • 1
  1. 1.General Surgery Division, Metabolic and Bariatric SurgeryEast Carolina University Vidant Medical CenterGreenvilleUSA

Personalised recommendations