2. Education
  3. Fellowship Programs
  4. Advanced GI/MIS and Bariatric Surgery Fellowship Program
  5. Case Requirements & Fellow Volumes

Case Requirements & Fellow Volumes

Fellowship Council Requirements

Our fellowship carries both an Advanced GI/MIS and Bariatrics designation. Minimum case requirements for the fellows are as follows:

Advanced GI (external link)/MIS Case Requirements

150 total complex MIS cases

65 Defined category MIS cases

  • 20 foregut cases
  • 25 bariatric cases
  • 10 inguinal hernia
  • 10 ventral hernia
  • Only complex (not basic) MIS Cases will count for credit.  A “Complex MIS Case” is defined as any laparoscopic or thoracoscopic operation with the exception of a cholecystectomy, appendectomy, or diagnostic laparoscopy as these are considered “basic MIS cases.” Complex MIS cases done robotically or with a SILS technique will count for credit; however, basic MIS cases done robotically or via a SILS approach will still be treated as basic MIS cases. MIS inguinal and ventral hernias are considered complex MIS cases and there is no limit regarding how many hernia cases may be counted for credit in addition to the defined hernia category minimums.
  • All Defined Category MIS Cases must be performed using an MIS approach and the fellow must serve as either the Primary Surgeon (PS) or Teaching Assistant (TA) for all of these cases.

85 Additional Complex MIS Cases

  • Up to 15 complex foregut, bariatric, or hernia cases may be performed using an open approach and will count for credit towards these 85 cases.
  • The fellow must serve as either PS or TA in at least 60 of these 85 cases. The fellow may serve as First Assistant (FA) in up to 25 of these 85 cases.
  • These 85 cases may consist of any complex MIS case type, including either the defined category case types (foregut, bariatric, or hernia) or other case types (colorectal, hepatobiliary, solid organ, thoracic, etc.).

150 Total Complex MIS Cases

Flexible Endoscopy – 50 Upper and Lower Endoscopies

  • Can be diagnostic or therapeutic
  • Endoscopies performed as part of a logged MIS case (e.g. EGD performed during fundoplication) will count for endoscopy credit

Bariatric (external link) Case Requirements

These requirements parallel the ASMBS Certificate criteria

  • 100 Bariatric cases with 65 as primary surgeon
  • 50 MIS Anastomotic cases with 30 as primary surgeon (including Roux -en-Y Gastric bypass, one anastomosis gastric bypass, Biliopancreatic Diversion +/- Duodenal Switch, or single-anastomosis duodenal switch variants [SIPS, SADI, SADS, etc.])
  • 40 MIS Restrictive operations with 30 as primary surgeon (Sleeve Gastrectomy operations and/or Adjustable Gastric Banding procedures)
  • 15 MIS or Open Revisional procedures with 5 as primary surgeon (Conversion or Reversal; excluding removal of adjustable gastric band; may double count as anastomotic or non-anastomotic)
  • 10 Hiatal Hernias with 5 as primary surgeon (may double count with a bariatric operation)
  • 10 Surgical management of bariatric complications with 5 as primary surgeon (may double count with an anastomotic bariatric case)
  • 25 Endoscopy (diagnostic or therapeutic)
  • Intraoperative and Separate Procedure
  • ESG
  • The fellow is required to complete 50 preoperative patient evaluations, 100 postoperative inpatient management encounters, and 100 postoperative outpatient evaluations.

Certifications

By completing the above case requirements, all fellows will complete the case volume requirements for an American Society of Metabolic and Bariatric Surgery (ASMBS) Fellowship Certificate (external link) and the SAGES Advanced GI MIS and Endoscopy (Comprehensive Flexible Endoscopy or Area of Concentrated Training Seal in Advanced Flexible Endoscopy) Certificate (external link). There are additional requirements that the fellow needs to complete, all of which are integrated into the fellowship year.

ASMBS Requirements (in brief)

  1. Completion of a Fellowship Council accredited program
  2. Completion and documentation of didactic educational sessions covering the ASMBS educational curriculum topics
  3. Participation in at least quarterly bariatric morbidity and mortality conferences
    Submission of an abstract to a national or regional society meeting during the fellowship
  4. Participation in bariatric multidisciplinary conferences
  5. 2026-2027 Requirements from the ASMBS
    Total weight loss operations: 150
    • Bariatric Cases (100 cases, 65 as primary surgeon)
      • 50 MIS anastomotic cases (30 as primary surgeon) (including Roux -en-Y Gastric bypass, one anastomosis gastric bypass, Biliopancreatic Diversion +/- Duodenal Switch, or single-anastomosis duodenal switch variants [SIPS, SADI, SADS, etc.])
      • 40 MIS restrictive operations (30 as primary surgeon) (Sleeve gastrectomy and/or adjustable gastric band)
      • 15 MIS or open revisional procedures (5 as primary surgeon) (Conversion or Reversal; excluding removal of adjustable gastric band; may double count as anastomotic or non-anastomotic)
    • Hiatal Hernias (10, 5 as primary surgeon)
      • May double count with a bariatric operation
    • Surgical management of bariatric complication (10, 5 as primary surgeon)
      • May double count with an anastomotic bariatric case
    • Endoscopy (25, diagnostic or therapeutic)
      • Intraoperative and separate procedure, includes ESG
  6. The fellow is required to complete 50 preoperative patient evaluations, 100 postoperative inpatient management encounters, and 100 postoperative outpatient evaluations.
  7. Program director fellow performance assessment interviews (at least twice during the fellowship year)

SAGES Requirements (in brief)

  1. SAGES membership
  2. Defined Category cases (150 total complex MIS cases)
    1. Foregut (20 cases)
    2. Bariatric (25 cases)
    3. Inguinal hernia (10 cases)
    4. Ventral hernia (10 cases)
    5. Additional complex MIS cases (85 cases)
    6. Fellows are encouraged to complete the requirements for comprehensive flexible endoscopy certification (external link) (minimum of 100 therapeutic endoscopy procedures) or area of concentrated training seal in advanced flexible endoscopy (external link) (minimum of 75 therapeutic endoscopic procedures). Details of the specific endoscopic case requirements are noted by following the links above.
  3. Program Director’s survey
  4. Submission of an abstract to a major meeting during fellowship
  5. Attendance of a major meeting during fellowship
  6. FLS, FES, and FUSE certification

Case Volumes for Past Fellows

Our program provides robust case volumes for the fellowship, as evidenced by the number of index cases performed by the fellows over the last 10 years. In addition to the index case volumes, fellows perform several hundred diagnostic and therapeutic endoscopies over the course of the year. All fellows have been able to meet the requirements for anastomotic cases set by the Fellowship Council and the ASMBS, in part, secondary to a large volume of revisional cases as well as multiple comprehensive bariatric surgery programs throughout the city for which UT faculty serve as medical directors.

 

Fellowship Year Index Case Volumes
Fellow 1/Fellow 2
2012-2013 541/468
2013-2014 782/607
2014-2015 540/638
2015-2016 629/703
2016-2017 268-179
2017-2018 397/432
2018-2019 564/438
2019-2020 376/466
2020-2021 448/493
2021-2022 403/388
2022-2023 409/343
2023-2024 457/367
2024-2025 456/425