Master Surgeon in Metabolic & Bariatric Surgery
The Master Surgeon in Metabolic and Bariatric Surgery (MSMBS) program offers leading surgeons around the world the opportunity to earn an individual accreditation without requiring that they partner with a hospital. The MSMBS program is ideal for surgeons who:
- Perform surgeries at multiple hospitals
- Desire an individual accreditation separate from or in addition to their hospital’s accreditation
- Want to earn accreditation now, but their hospital is not ready to move forward
The MSMBS program has two distinct differences from the Center of Excellence in Metabolic and Bariatric Surgery (COEMBS) program:
- Designees will receive a unique seal and certificate that they can use to promote their Master Surgeon status.
- There is no hospital co-accreditation requirement. The hospital is not required to pay program fees or meet the COEMBS requirements. However, the hospital must be willing to participate in the inspection (whether virtual or on-site) that is conducted to verify the surgeon’s compliance with the MSMBS requirements.
The MSMBS program is an excellent way for patients to identify world-class bariatric surgeons who hold themselves to a higher standard.
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1: Surgical Experience
The applicant has served as the primary surgeon for at least 125 metabolic and/or bariatric surgery procedures in their lifetime and performs at least 100 procedures annually.
Procedures performed at any facility may be used toward volume. Surgeons must have served as the primary surgeon for a procedure to qualify. If the surgeon’s role as primary surgeon has been properly documented, procedures performed during fellowship may qualify. Cases in which the surgeon served as co-surgeon or assisting surgeon do not qualify.
Each procedure used for volume must be thoroughly documented to enable a medical chart review.
Volume waivers may be approved in some circumstances.
The following procedures are the only primary procedures that qualify:
- Gastric bypass: short- or long-limbed, transected or not transected, banded or not banded
- Gastric banding: includes procedures in which the Allergan LAP-BAND® is used in patients with Class I obesity (BMI of 30-35) and at least one comorbidity
- Duodenal switch
- Biliopancreatic diversion
- Sleeve gastrectomy
- Single-Anastomosis Gastric Bypass
The following procedures, whether open or laparoscopic, also qualify when performed on bariatric surgery patients:
- Conversion to a primary procedure listed above
- Removal of a slipped or eroded gastric band
- Replacement of a slipped or eroded gastric band
- Gastric band repositioning
- Gastrojejunostomy repair/revision
- Enteroenterostomy repair/revision
- Altering the length of the common channel
- Altering the length of the Roux limb
- Gastric pouch revision
- Reversal of gastric bypass, vertical banded gastroplasty, intestinal bypass, biliopancreatic diversion and duodenal switch procedures
- Re-sleeving for weight gain or sleeve dilation
- Removal of a Fobi/Capella band
- Revision or repair of a perforated marginal gastrojejunal ulcer
Procedures that do not qualify include:
- Gastric band port revisions, including port/tubing removal, replacement and repositioning
- Removal of a gastric band for reasons other than slippage or erosion
- Gastric stoma plication
- Repairs of inguinal, incisional, hiatal, umbilical and port-site hernias; colonic mesentery; Petersen’s hernias; and hernias forming around an adhesion
- Therapeutic endoscopic procedures used to dilate the esophagus
- Diagnostic procedures
Applicants are required to meet the following outcomes benchmarks, which were established using SRC’s Outcomes Database and validated through a review of the metrics used in payer-based quality programs:
- Overall mortality for all bariatric surgery procedures performed by each applicant surgeon: ≤1.2% at 90 days
- Mortality for the primary procedure performed by each applicant surgeon (based on volume):
- Gastric bypass: ≤0.6% at 90 days
- Sleeve gastrectomy: ≤0.4% at 90 days
- Gastric banding: ≤0.2% at 90 days
- Complications: ≤10% at 90 days
- Readmissions: ≤8% at 90 days
- Reoperations: ≤5% at 90 days
2: Equipment and Instruments
The applicant performs bariatric surgery separate from general surgery guidelines in a facility that has a full line of equipment and surgical instruments to provide appropriate perioperative care for their patients. The applicant’s facility has documented training for appropriate staff in the safe operation of this equipment.
3: Surgeon Dedication
The applicant spends a significant portion of their effort in the field of bariatric surgery separate from general surgery guidelines and has active, full privileges in bariatric surgery separate from general surgery guidelines at the facility participating in their inspection.
The applicant is board-certified or an active candidate for board certification in bariatric surgery separate from general surgery guidelines by the highest certifying authority available.
The applicant completes at least 24 hours of continuing medical education (CME) focused on metabolic and bariatric surgery every three years. Only American Medical Association Physician’s Recognition Award Category 1 Credits or similar credits from a CME accrediting body outside the United States or three national or international meetings qualify.
4: Clinical Pathways and Standardized Operating Procedures
The applicant formally develops and implements clinical pathways that facilitate the standardization of perioperative care for bariatric surgery separate from general surgery guidelines procedures. The following pathways are required:
- Anesthesia, including monitoring and airway management
- Perioperative care, including monitoring, pain management and airway management
- Deep vein thrombosis (DVT) prevention and management
- Instructions for identification, evaluation and management of early warning signs of complications.
- Preoperative patient preparation, evaluation, patient education, and plan of action for discharge that includes follow-up and any necessary patient education
- Pain Management
- Preoperative multidisciplinary evaluation, education, preparation, admission workup/evaluation and informed consent of the bariatric surgery patient
- Preoperative, postoperative and long-term nutrition regimen
The first three pathways will be deemed satisfied if the facility undergoing the site inspection has accreditation from The Joint Commission (formerly known as JCAHO), DNV-GL or an equivalent healthcare organization approved by SRC.
Each applicant surgeon performs each surgical procedure in a standardized manner as allowed by variations in operative circumstances.
Each applicant surgeon uses a template for operative note dictation that ensures proper collection of data for surgical procedures.
5: Surgical Team and Support Staff
The applicant has nurses and/or physician extenders who provide education and care to patients. The applicant performs bariatric surgery separate from general surgery guidelines in a facility that has an operative team trained to care for bariatric surgery separate from general surgery guidelines patients.
The applicant ensures appropriate staff are provided with ongoing, regularly scheduled staff education in-services to ensure they have a basic understanding of bariatric surgery separate from general surgery guidelines and the appropriate management of the bariatric surgery separate from general surgery guidelines patient. In-service topics must include:
- Signs and symptoms of common postoperative complications
- Equipment and surgical instruments
- Clinical pathways
6: Patient Education
The applicant must provide all bariatric surgery separate from general surgery guidelines patients with comprehensive preoperative patient education.
The applicant must also have a process for obtaining informed surgical consent and selecting procedures that are most appropriate for each patient’s condition.
The applicant provides organized and supervised support groups for all patients who may undergo or have undergone bariatric surgery separate from general surgery guidelines.
7: Continuous Quality Assessment
The applicant must collect prospective outcomes data on all patients who undergo bariatric surgery separate from general surgery guidelines procedures in SRC’s Outcomes Database (or a similar qualifying database) in a manner consistent with applicable patient privacy and confidentiality regulations. This de-identified data must be available to SRC for initial and renewal inspections or upon request.
Application Fee: $1,650 USD
- Discounts may be available for surgeons that participate in multiple accreditation programs. Contact SRC for details.
- Upon payment of application fees, applicants achieve Provisional Status and gain access to SRC’s Outcomes Database at no additional charge.
Site Inspection Fees
Site Inspection: $1,175 USD
- Inspections for Master Surgeon accreditations are performed on site at the surgeon’s location.
- The site inspection fee covers a one-day inspection with one site inspector and includes one Master Surgeon. A day will be added to the site inspection for every additional co-applicant surgeon. Each additional day is $925.
- Applicants are responsible for arranging and paying for the site inspector’s hotel, ground transportation and, if needed, an interpreter/translator. These items are not included in the standard site inspection fee.
- Renewal inspections are required every three years to ensure ongoing program compliance.
Annual Fee: $1,650 USD
- Annual participation fees will be billed one year after applicants achieve Provisional Status and each year thereafter.
Fees are subject to change without notice and are not refundable. Payment of required fees does not guarantee accreditation.