Publications by authors named "Scott A Shikora"

Introduction: Metabolic and bariatric surgery (MBS) has been an established treatment option for patients with Type 2 diabetes mellitus (T2DM), but there is a relative paucity of evidence-based guidelines on preoperative, operative, and postoperative considerations concerning metabolic surgery for T2DM patients. To address this gap, we initiated a Delphi consensus process with a diverse group of international multidisciplinary experts.

Method: We embarked on a Delphi consensus-building exercise to propose an evidence-based expert consensus covering various aspects of MBS in patients with T2DM.

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Despite the growing popularity of one anastomosis gastric bypass (OAGB) as the third most commonly performed metabolic and bariatric surgery (MBS) procedure worldwide, concerns remain among MBS surgeons about performing OAGB in children and adolescents. This international expert survey was conducted to assess the perspectives of experts regarding the different aspects of OAGB specific to these patient groups. A total of 102 expert MBS surgeons from 41 countries were invited to participate in this survey, which took place between 24 May 2024, and 11 June 2024.

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Artificial intelligence (AI) is transforming the landscape of medicine, including surgical science and practice. The evolution of AI from rule-based systems to advanced machine learning and deep learning algorithms has opened new avenues for its application in metabolic and bariatric surgery (MBS). AI has the potential to enhance various aspects of MBS, including education and training, decision-making, procedure planning, cost and time efficiency, optimization of surgical techniques, outcome and complication prediction, patient education, and access to care.

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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.
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Purpose: There is a lack of evidence for treatment of some conditions including complication management, suboptimal initial weight loss, recurrent weight gain, or worsening of a significant obesity complication after one anastomosis gastric bypass (OAGB). This study was designed to respond to the existing lack of agreement and to provide a valuable resource for clinicians by employing an expert-modified Delphi consensus method.

Methods: Forty-eight recognized bariatric surgeons from 28 countries participated in the modified Delphi consensus to vote on 64 statements in two rounds.

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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
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Purpose Of Review: Gastroparesis is a chronic disorder characterized by a constellation of foregut symptoms, including postprandial nausea, vomiting, distension, epigastric pain, and regurgitation in the absence of gastric outlet obstruction. Despite considerable research over the past decades, there remains to be only nominal understanding of disease classification, diagnostic criteria, pathogenesis, and preferred therapy.

Recent Findings: We critically reassess current approaches for disease identification and stratification, theories of causation, and treatment for gastroparesis.

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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.

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Background: Hospital readmission (HR) rates following metabolic/bariatric surgery (MBS) are used as a surrogate for quality outcomes and are increasingly tied to reimbursement rates. There are limited data concerning predictors of HR rates with regard to type of bariatric procedure.

Methods: This study is a retrospective review of prospectively collected data from patients who underwent MBS from January 2014 to December 2019 at Brigham and Women's Hospital in Boston, Massachusetts.

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Introduction: Previous studies have demonstrated that one anastomosis gastric bypass (OAGB) is not inferior to Roux-en-Y gastric bypass (RYGB) in treating obesity. However, high level evidence comparing the efficacy and safety of both procedures in type 2 diabetes (T2D) treatment is still lacking, which is another main aim of bariatric surgery. The presented trial has been designed to aim at investigating the superiority of OAGB over the reference procedure RYGB in treating T2D as primary endpoint.

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Background: Laparoscopic surgery has almost replaced open surgery in many areas of Gastro-Intestinal (GI) surgery. There is currently no published expert consensus statement on the principles of laparoscopic GI surgery. This may have affected the training of new surgeons.

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Background: Obesity is a risk factor for gallstone formation, which can be exacerbated by bariatric surgery-induced rapid weight loss. Current guidelines do not recommend concomitant cholecystectomy (CC) for asymptomatic gallstones during the bariatric surgery procedure. However, long-term follow-up studies have shown that the incidence of post-bariatric surgery symptomatic gallstones necessitating therapeutic cholecystectomy increases to 40%.

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Introduction: 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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