This topic can generate some controversy since it is based on the experience that we have acquired during the more than 11 years that we have been performing bariatric surgery in basically only two procedures.
In our opinion, those bariatric practices or bariatric surgeons who are dedicated to offering more than two or three weight loss procedures run the risk of not developing sufficient experience and skills, which are extremely necessary to provide the best possible results to their patients.
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Bariatric surgery is a very "jealous" general surgery subspecialty that requires the maximum skill, theoretical and technical knowledge possible to minimize the chances of a complication or suboptimal results, and this is simply because they are procedures that at first glance might seem simple or technically non demanding without really being easy at all.
In our professional practice and since I was in my training as a surgeon, I have been learning many details that cannot be learned in any another way than with practice and repetition. Being day in and day out performing the same 2 or 3 procedures for more than a decade is the only thing that allows improving the surgical technique and the pre and post-operative management of patients. And each bariatric procedure has certain aspects and critical points that are unique.
That is why, in my opinion, in order to offer the highest quality in terms of final results and minimum or no complications as obesity surgeons, we are obliged not to want to cover too much in this incredible field of surgery.
I think we, as bariatric surgeons are obliged to recognize our limitations, be objective and think about the well-being of our patients, so although I know that there are surgeons who consider themselves very capable (and most likely they are) to offer the procedure that each patient requests, offering a portfolio of 5 or 6 different procedures, performing gastric bypass in 90% of their cases and only 10% for three or four other procedures.
It is very likely that if they perform a gastric bypass routinely and occasionally a gastric sleeve (as simple as it may seem) they are not as experienced and do not have all the technical and theoretical knowledge to offer said patient the optimal results, so that said patient, in ideal conditions, should be referred to another colleague who does the gastric sleeve in 90% of his patients and so this surgeon can offer better results than the first one.
It might seem like a complicated explanation, but it really isn't when we compare it with an example of everyday life such as having a house built with the advice of a civil engineer versus an architect. Both have knowledge that allows them to achieve the construction of a house, but their way of addressing the challenge will be different based on the areas in which they are experts, and therefore the results will be different from the structural and aesthetic point of view. The same happens when the bariatric surgeon wants to offer too many procedures in his professional practice.
Medicine and specifically the area of surgery has evolved dramatically in recent decades, and that is why there are more and more subspecialties, but even within subspecialties, there are experts who focus on a single procedure.
There are expert bariatric surgeons in gastric bypass, we have expert surgeons in gastric sleeve, expert surgeons in duodenal switch, experts in single anastomosis bypass (mini-gastric bypass or BAGUA), experts in SADI, and we could extend the list to reach more than 10 different bariatric procedures that have the same purpose, improve the quality of life and health of our patients.
Finally but equally important, the bariatric surgeon who, as a server myself, am practically dedicated to performing a single procedure, must have sufficient professional and moral ethics to avoid seeking to convince the patient to perform said procedure, since each case is unique and deserves an extensive analysis of which procedure will be the one that best suits the needs of the patient, and if said procedure is not the one offered, refer the case to a colleague who does this procedure more regularly.
We remain open to your questions and opinions regarding this issue and any other. Let us know how we can guide you.