Quality in Bariatric Surgery

  • Robin P. Blackstone
  • Thomas P. Petrick
  • Anthony T. PetrickEmail author


The movement to reduce unjustified variation in care delivery has become a critical component of initiatives to improve the outcomes of surgical procedures and value in healthcare. Surgeons have been at the forefront of quality improvement throughout the history of American medicine. This was particularly true in metabolic and bariatric surgery. Surgical approaches to the treatment of obesity grew slowly from the 1960s to the 1990s with limited adoption. With the demonstration that laparoscopic gastric bypass was feasible, safe, and effective in the late 1990s, the field grew at a rapid pace with wide variation in morbidity and mortality. Societies, regional collaboratives, and individual surgeons responded by creating pathways to provide a structure of programmed longitudinal care. A multidisciplinary team-based approach was developed for patient care, data collection, outcomes reporting, and quality improvement. Reporting structures were unreliable prior to these efforts. In 1999, mortality was reported as 4% for Medicare patients in Washington state. By 2017, mortality had been reduced to 0.08%, for all bariatric procedures in the United States with a highly reliable reporting structure available to all surgeons and hospitals. In the history of surgery, there may not have been a more comprehensive, cooperative, or successful quality improvement effort to ensure access and safe care for patients. This chapter examines the history and current state of quality in metabolic and bariatric surgery.


Obesity Quality improvement MBSAQIP Value Cost Accreditation Collaborative 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Robin P. Blackstone
    • 1
  • Thomas P. Petrick
    • 2
  • Anthony T. Petrick
    • 3
    Email author
  1. 1.Metabolic and Bariatric SurgeryBanner University Medical Center – PhoenixPhoenixUSA
  2. 2.Department of SurgeryChinle Comprehensive Health Care FacilityChinleUSA
  3. 3.Geisinger Medical CenterDanvilleUSA

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