Bariatric surgery in Poland, 2023: growth, trends, and impact of the KOS‑BAR program.

Introduction: Bariatric surgery is an effective treatment for obesity and metabolic disorders. In Poland, the growing prevalence of obesity has led to an increase in the demand for these procedures. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the most frequently performed surgeries, while newer techniques, such as single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S), single-anastomosis sleeve ileal bypass (SASI), and Nissen sleeve gastrectomy (N-SG) are emerging. The Comprehensive Specialist Care in Bariatrics (KOS-BAR) program, introduced in 2021, aims to standardize bariatric care in Poland.

Aim: This study evaluates the state of bariatric surgery in Poland in 2023, focusing on procedure volumes, regional variations, and the role of KOS-BAR centers.

Materials and methods: A nationwide survey was conducted among bariatric surgery centers affiliated with the Metabolic and Bariatric Surgery Chapter of the Association of Polish Surgeons. Data on the number and types of surgeries performed in 2023 were collected and compared with previous reports to analyze trends.

Results: A total of 54 centers, including 18 KOS-BAR centers, participated in the survey, reporting a total of 9102 procedures performed in 2023. SG accounted for 82% of surgeries, followed by RYGB (9.7%) and one anastomosis gastric bypass (3.9%). Newer procedures, such as N-SG (0.4%), SASI (0.8%), and SADI-S (0.2%) were less frequently performed. Over a half of all surgeries (59.3%) were performed in KOS-BAR centers. Significant regional variations in procedure volumes were observed.

Conclusions: Bariatric surgery in Poland has seen substantial growth, with SG as the dominant procedure. However, regional disparities in access to care and the limited adoption of newer techniques persist. Expanding services to underserved regions and establishing a national registry are crucial for improving patient care and outcomes.