SynthesisThe British journal of surgery2026
Navigating uncharted territory in surgical innovation: systematic review of non-standard metabolic bariatric surgery procedures.
Synthesis in The British journal of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSurgical innovation often outpaces robust evaluation. This study used metabolic bariatric surgery (MBS), a field of high-intensity innovation, as a case study to evaluate reporting standards and ethical oversight for experimental procedures within surgery.
methodsA systematic review was conducted in accordance with PRISMA 2020 guidelines. PubMed/MEDLINE, the Web of Science, Scopus, the Cochrane Library, and Embase were searched from January 2000 to December 2024 using terms related to MBS, surgical innovation, and non-standard intestinal bypass procedures. Original studies reporting first-in-human or early clinical series of non-standard primary MBS involving significant intestinal modification were included and reviews, editorials, conference abstracts, revisional surgery, purely restrictive procedures, and device-based interventions were excluded. Two reviewers independently screened studies, extracted data on publication timing, patient numbers, follow-up, ethical approval, and trial registration, and assessed risk of bias using the Newcastle-Ottawa scale (NOS), the Joanna Briggs Institute critical appraisal checklist, and the ROBINS-I tool.
resultsFrom 57 included studies (10 754 patients), the median time from first human operation to publication was 5 (interquartile range 3-8) years. The median initial cohort size was 39 (range 1-1074) patients. Institutional Review Board or ethics committee approval was reported in 47 of 57 studies (82%), while prospective clinical trial registration was documented in only 6 of 57 studies (11%). Methodological quality was low (mean NOS score of 5.0 out of 9), with 56 of 57 studies judged at high risk of bias. Out of 57 studies, only 15 (26%) reported outcomes at ≥3 years and only 8 (14%) reported outcomes at ≥5 years.
conclusionThis MBS case study reveals delayed publication and a widespread lack of prospective trial registration, exposing over 10 000 patients to experimental procedures outside a transparent research framework. These findings highlight a systemic failure in surgical innovation governance and underscore an urgent need for a cultural shift towards mandatory, prospective oversight frameworks to ensure patient safety and credible evidence generation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.