IFSO Worldwide Survey 2020–2021: Current Trends for Bariatric and Metabolic Procedures
Authors: Angrisani Luigi , Santonicola Antonella , Iovino Paola , Palma Rossella , Kow Lilian , Prager Gerhard , Ramos Almino , Shikora Scott ,   the Collaborative Study Group for the IFSO Worldwide Survey, Fiolo Felipe , Harraca Jorge L. , Hamdorf Jeff , Langer Felix , Beckerhinn Philipp , Omerov Taryel , Dillemans Bruno , Rodriguez Erick Hassan Bakry , Viegas Fabio , Grozdev Konstantin , Anvari Mehran , Glazer Stephen , Wilson Camilo Boza , Bastidas Francisco Pacheco , Yang Wah , Wang Cunchuan , Lopez Luis Ernesto , Pedonomou Marios , Hruby Martin , Haluzik Martin , Domingo Ricardo , Garcia Pablo , Guerron Daniel , Gawdat Khaled , Abbas Alaa , Velarde Tatiana , Salminen Paulina , Frering Vincent , Birk Dieter , Skroubis George , Pappis Harry , Montufar Fernando , Wong Simon , Raj Praveen , Khalaj Alireza , Al Mukhtar Ramiz , Sakran Nasser , Zappa Marco Antonio , Okazumi Shinichi , Matsubara Hisahiro , Haddad Ashraf , Ahmad Sami Salem , Ospanov Oral , Kim Dong Jin , Lee Sang Kuon , Maleckas Almantas , Kosai Nik Ritza , Villarreal José G. Rodríguez , Nienhuijs Simon , Emous Marloes , Kristinsson Jon , Bareiro Ricardo Olmedo , Tarnowski Wieslaw , Santos Jorge , Khidir Nesreen Mahmoud , Copaescu Catalin , Khatsiev Bekkhan , Alqahtani Aayed , Guowei Kim , Tan Chun Hai , Pintar Tadeja , van der Merwe Tess , Antona Esteban Martin , Pernaute Andrés Sánchez , Ottosson Johan , Olbers Torsten , Bauknecht Felix , Bueter Marco , Wang Weu , Taskin Halit Eren , Sahin Mustafa , Alkhafaji Basim , Alwahidi Abdulwahid , Menon Vinod , Sauto Sergio , Clapp Benjamin , LaMasters Teresa , Cordova Luis Rafael Level 
Published: March 2024

Abstract
Purpose
This IFSO survey aims to describe the current trends of metabolic and bariatric surgery (MBS) reporting on the number and types of surgical and endoluminal procedures performed in 2020 and 2021, in the world and within each IFSO chapter.

Methods
All national societies belonging to IFSO were asked to complete the survey form. The number and types of procedures performed (surgical and endoluminal interventions) from 2020 to 2021 were documented. A special section focused on the impact of COVID-19, the existence of national protocols for MBS, the use of telemedicine, and any mortality related to MBS. A trend analysis of the data, both worldwide and within each IFSO chapter, was also performed for the period between 2018 and 2021.

Results
Fifty-seven of the 74 (77%) IFSO national societies submitted the survey. Twenty-four of the 57 (42.1%) reported data from their national registries. The total number of surgical and endoluminal procedures performed in 2020 was 507,806 and in 2021 was 598,834. Sleeve gastrectomy (SG) remained the most performed bariatric procedure. Thirty national societies (52%) had regional protocols for MBS during COVID-19, 61.4% supported the use of telemedicine, and only 47.3% collected data on mortality after MBS in 2020. These percentages did not significantly change in 2021 (p > 0.05).

Conclusions
The number of MBS markedly decreased worldwide during 2020. Although there was a positive trend in 2021, it did not reach the values obtained before the COVID-19 pandemic. SG continued to be the most performed operation. Adjustable gastric banding (AGB) continues to decrease worldwide.

Graphical Abstract