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Background

Bariatric tourism has experienced a significant rise in demand since the turn of the century, allowing patients to circumvent barriers such as financial cost/insurance. However, uncertainty remains regarding safety and efficacy. We analyzed the safety and efficacy of a high volume bariatric tourism program in TJ that follows ASMBS/ACS guidelines and regulations.

Methods

A retrospective review was performed identifying bariatric tourism operations performed in a Joint Commission International Accredited center. All patients underwent a standardized protocol including an online bariatric education program, a nutritionist guided pre-operative weight loss program and pre-operative internal medicine and psychological evaluation. All patients underwent a barium swallow 72 hours post-operatively. Demographic and post-operative data were collected.

Results

19801 patients were identified in a 20 year period (04/2000 to 10/2021). The average age was 42.2 years (13-78 ), BMI 42.3 (25.22-76). 53.1% of the operations were sleeve gastrectomies, 38.2% adjustable gastric band (AGB), and 8.7% gastric bypass. 9.7% of cases were revisional. The average length of stay was 22.4 hours with follow up to 24 months.The average EWL at 2 years was 76.18%. The total 30-day morbidity rate was 1.2%: intra-abdominal bleed (0.001%), acute incarcerated hiatal hernia (0.001%), gastric outlet obstruction (0.001%), venous thrombosis (0.0006%), intrabdominal infection (0.0002%), pulmonary embolism (0.0002%), acute gastric leak (0.00005%). There were no mortalities.

Conclusions

Our study demonstrates that bariatric tourism when performed in an accredited center is both safe and effective. The keys to success include a standardized and regimented program ensuring patient compliance and quality provider care.