Wrap Up Discussions - 2024 Pediatric Bariatric Surgery Update Course

MBSAQIP criteria for freestanding pediatric centers require 100 lifetime cases, 75 of which can be completed during fellowship training, and 20 cases per year to be an MBS director or verified MBS surgeon

If partnering with an adult program, pediatric surgeons do not need to meet individual verification requirements because adult surgeons serve as the verified surgeons

Annual case volume requirements were reduced to 15 per year for pediatric centers

Partnering with an adult surgeon for 1-3 years until reaching 100 cases and 15 annual program cases allows transition to independent practice

Medicaid reimbursement for facility fees averages about 50% and is often better than private payers in some regions

Every sleep study, radiology test, and lab test generates a facility fee, making overall payment for bariatric patients substantial

Some adult hospitals sustain their operations primarily through their bariatric programs

The robotic surgery system has an excellent simulator that allows extensive practice before patient cases

Microbiome composition changes for the better after bariatric surgery in adolescents, with increases in beneficial species like Firmicutes

It is nearly impossible to separate whether microbiome changes are the cause or effect of weight loss without fecal transplant studies

Twenty years ago there was a huge disparity between the kids getting bariatric surgery and the kids who needed bariatric surgery

With 500 pediatric bariatric cases nationally, the field is not moving the needle on the obesity epidemic

An adult bariatric surgeon completed 4 bariatric cases by 11 o'clock using robotic surgery with 2 rooms flipping

The quality of robotic instruments and staplers for the newer systems is significantly improved compared to earlier 8mm instruments

The pharmaceutical industry has significant interest in proving pharmacologic treatment is the best method for treating obesity

Medical schools need to teach about obesity as a disease in pathophysiology curricula to address weight bias and stigma within the medical profession

The vast majority of medical schools are not adequately teaching about the disease of obesity