Kuwait MoH sets stricter standards for MBS

Minister of Health (MoH) of Kuwait has issued new standards for regulating metabolic bariatric surgeries (MBS) and non-surgical interventional procedures in public and private healthcare facilities. The Ministry has established a comprehensive regulatory framework based on clear standards covering healthcare facilities, medical practitioners, patient selection and assessment, follow-up procedures, and monitoring of outcomes and complications.

The standards take effect immediately and will be published in the Official Gazette,replacing any previous decisions or provisions that conflict with its terms. It defines the scope of MBS and classifies procedures into primary, reconstructive and malabsorptive surgeries. It also regulates non-surgical interventions, including laparoscopic sleeve gastrectomy and gastric balloon placement, while setting specific requirements and standards for each category.

Approved primary procedures include sleeve gastrectomy, gastric bypass, mini-gastric bypass and gastric banding. The new standards state that there is no fixed upper age limit for bariatric surgery, with eligibility determined according to the patient’s overall health condition. It also allows selected children and adolescents aged 12 to 17 to undergo bariatric surgery, subject to specific criteria, comprehensive medical assessment, approval by a multidisciplinary team and written informed consent from parents or legal guardians.

Patients undergoing surgery must receive medical follow-up for at least two years after the procedure. The new standards establishe specific criteria related to body mass index and co-existing medical conditions, with recommended procedures for younger patients limited to sleeve gastrectomy and gastric bypass in selected cases.

The regulations also cover reconstructive and malabsorptive surgeries, outlining the circumstances in which reconstructive procedures may be considered. These include significant weight regain or inadequate weight loss following previous MBS, insufficient improvement in co-existing conditions, and treatment of complications such as severe gastroesophageal reflux disease.

All cases involving reconstructive or malabsorptive surgery must be reviewed by a multidisciplinary team, with formal and documented approval required before the procedure is performed. The ministry clarified that malabsorptive procedures cannot be performed as primary surgeries and may only be carried out by surgeons with extensive experience and proven expertise in the specific procedure. The measure is intended to enhance patient safety and ensure that complex procedures are entrusted to appropriately qualified specialists.

The new standards limits bariatric surgery to government hospitals and licensed, qualified private hospitals. Private facilities must have appropriate infrastructure, including intensive care units, medical imaging and laboratory services, as well as comprehensive pre-operative assessment protocols. It also requires the immediate reporting of serious complications classified as Grade 3 or higher under the Clavien-Dindo classification, as well as any deaths. Specific reporting procedures have been established for both the public and private sectors.

In addition, the new standards mandates the establishment and maintenance of a national registry for bariatric surgeries, covering all cases, outcomes and complications. The registry will support national-level monitoring of quality and evaluation of surgical outcomes. The ministry said the new standards also regulate the transfer of patients from private to public hospitals, requiring strict compliance with the ministry’s approved patient transfer policy. All medical reports and examination results, together with documentation of the surgical procedure or operative findings, must be submitted within 24 hours.

The new standards further sets professional qualification requirements for physicians performing bariatric procedures. Surgeons must be senior specialists or consultants in general surgery and hold appropriate training or accredited qualifications in bariatric surgery in accordance with applicable regulations. Surgical departments are required to maintain updated lists of experienced bariatric surgeons and review and approve these lists periodically. The regulations also govern the work of visiting surgeons, including their licensing requirements and approval of the procedures they are authorized to perform.