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Surgical specialties

Upper GI and Bariatric Surgery Diploma

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A live online diploma in upper gastrointestinal (GI) and bariatric surgery: the decisions that matter in benign and malignant disease of the oesophagus and stomach, in hepatopancreatobiliary (HPB) surgery of the liver, pancreas and bile ducts, and in metabolic and bariatric surgery for obesity and type 2 diabetes.

Twenty-five weekly sessions across five modules are anchored on guidance from the UK's National Institute for Health and Care Excellence (NICE) and the European specialty societies, with US differences flagged where they change practice, and are taught live by practising specialists you can question, with cases worked through as a multidisciplinary team (MDT) would.

Course director
To be announced
Format
25 live weekly sessions on Zoom, in 5 modules
Dates
Confirmed when enrolment opens

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Barium contrast X-ray showing the oesophagus and a contrast-filled stomach that has moved up into the chest.
Image: barium swallow of a hiatus hernia by Hellerhoff via Wikimedia Commons, licensed under CC BY-SA 4.0.

Who it is for

Senior trainees, fellows and early-career consultants in upper GI, HPB, bariatric and general surgery, worldwide.

The programme

25 one-hour sessions in 5 modules, each with its learning objectives. This is the draft programme: the course director reviews and refines it before enrolment opens, so session titles may change.

Module 1 · Sessions 1 to 5Benign oesophagus and stomach

  1. 1. Reflux disease and antireflux surgery

    • Confirm reflux disease with endoscopy and physiology testing before offering surgery
    • Select patients for laparoscopic fundoplication using current criteria
    • Explain the evidence on endoscopic and device-based alternatives to fundoplication
    • Manage dysphagia and gas bloat after antireflux surgery

  2. 2. Large hiatus and paraoesophageal hernia

    • Decide when a paraoesophageal hernia should be repaired electively
    • Recognise acute gastric volvulus and plan emergency management
    • Weigh the evidence for mesh reinforcement of the crural repair
    • Counsel older patients on the risks and benefits of repair

  3. 3. Achalasia and oesophageal motility disorders

    • Interpret a high-resolution manometry report using the Chicago Classification v4.0
    • Choose between pneumatic dilatation, Heller myotomy and peroral endoscopic myotomy
    • Manage recurrent dysphagia and reflux after achalasia treatment
    • Recognise pseudoachalasia and other mimics that need investigation

  4. 4. Barrett's oesophagus and early neoplasia

    • Apply surveillance intervals for Barrett's oesophagus in line with current guidance
    • Choose between endoscopic resection, ablation and surgery for early neoplasia
    • Interpret pathology after endoscopic resection to decide on further treatment
    • Explain the risk of progression to a patient with Barrett's oesophagus

  5. 5. Oesophageal emergencies and benign gastric outlet obstruction

    • Diagnose oesophageal perforation early and choose between conservative, endoscopic and surgical care
    • Manage caustic ingestion with endoscopic assessment and timely surgery
    • Plan the removal of an impacted oesophageal foreign body
    • Manage benign gastric outlet obstruction
Module 2 · Sessions 6 to 10Oesophagogastric cancer

  1. 6. Diagnosis, staging and the oesophagogastric multidisciplinary team

    • Stage oesophageal and gastric cancer using CT, PET-CT, endoscopic ultrasound and laparoscopy
    • Assess fitness, nutrition and frailty before radical treatment
    • Present a case at the oesophagogastric MDT with the information needed for a decision
    • Identify patients who need early palliative care rather than radical treatment

  2. 7. Oesophageal cancer: neoadjuvant treatment and active surveillance

    • Choose neoadjuvant treatment for oesophageal adenocarcinoma using current trial evidence
    • Decide between definitive chemoradiotherapy and surgery for squamous cell carcinoma
    • Identify patients who should be offered adjuvant immunotherapy
    • Discuss active surveillance after a clinical complete response with a patient

  3. 8. Oesophagectomy

    • Choose an oesophagectomy approach for tumour site and patient fitness
    • Compare open, hybrid and minimally invasive approaches using trial evidence
    • Apply enhanced recovery principles after oesophagectomy
    • Explain how centre volume and audit affect outcomes

  4. 9. Gastric cancer and gastric stromal tumours

    • Plan perioperative treatment and the extent of gastrectomy for gastric cancer
    • Select early gastric cancers for endoscopic resection
    • Counsel a carrier of a hereditary diffuse gastric cancer gene variant about prophylactic total gastrectomy
    • Manage a gastric stromal tumour according to its size, site and risk

  5. 10. Complications, nutrition and palliation after oesophagogastric surgery

    • Recognise and manage an anastomotic leak or conduit necrosis after oesophagectomy
    • Manage chyle leak and recurrent laryngeal nerve injury
    • Plan long-term nutrition support after oesophagectomy and gastrectomy
    • Choose a palliative option for malignant dysphagia or gastric outlet obstruction
Module 3 · Sessions 11 to 15Hepatopancreatobiliary surgery

  1. 11. Gallbladder and bile duct beyond the emergency

    • Apply the joint European guideline to the management of gallbladder polyps
    • Manage gallbladder cancer found incidentally after cholecystectomy
    • Choose between single-stage laparoscopic bile duct exploration and endoscopic clearance
    • Recognise complex biliary anatomy that needs referral to a hepatobiliary unit

  2. 12. Chronic pancreatitis and pancreatic cysts

    • Plan investigation and pain management in chronic pancreatitis
    • Decide when endoscopic or surgical treatment of chronic pancreatitis is indicated
    • Apply European and international criteria to choose surveillance or resection for pancreatic cysts
    • Prescribe pancreatic enzyme replacement and recognise diabetes caused by pancreatic disease

  3. 13. Pancreatic cancer: resectability and neoadjuvant treatment

    • Classify pancreatic cancer as resectable, borderline or locally advanced on CT
    • Decide between upfront surgery and neoadjuvant treatment
    • Explain adjuvant chemotherapy options and the evidence behind them
    • Prescribe pancreatic enzyme replacement in line with NICE NG85

  4. 14. Pancreatoduodenectomy and its complications

    • Grade a postoperative pancreatic fistula using the international definition
    • Apply an algorithm for early recognition and management of complications
    • Manage post-pancreatectomy haemorrhage with interventional radiology
    • Explain the evidence for minimally invasive pancreatic resection

  5. 15. Liver lesions and liver surgery

    • Characterise a liver lesion and decide who needs biopsy, surveillance or resection
    • Assess the future liver remnant before major hepatectomy
    • Choose between resection, ablation and transplant referral for hepatocellular carcinoma
    • Plan the sequencing of colorectal liver metastasis surgery with the colorectal team
Module 4 · Sessions 16 to 20Metabolic and bariatric surgery

  1. 16. Obesity as a disease and selection for surgery

    • Assess eligibility for metabolic and bariatric surgery using UK and international criteria
    • Apply ethnicity-adjusted thresholds when assessing people for surgery
    • Coordinate multidisciplinary assessment, including psychological and dietetic review
    • Explain where obesity medicines fit before, instead of or after surgery

  2. 17. Choosing the operation

    • Compare sleeve gastrectomy, Roux-en-Y gastric bypass and one anastomosis gastric bypass using trial evidence
    • Choose an operation that suits the patient's reflux, diabetes and nutritional risk
    • Explain long-term weight and metabolic outcomes honestly
    • Plan follow-up for reflux and Barrett's oesophagus after sleeve gastrectomy

  3. 18. Metabolic surgery for type 2 diabetes and fatty liver disease

    • Select people with type 2 diabetes for metabolic surgery
    • Explain the randomised evidence comparing surgery with medical therapy
    • Assess and refer steatotic liver disease before and after bariatric surgery
    • Plan changes to diabetes medicines around surgery with the diabetes team

  4. 19. Early complications and the bariatric patient in the emergency department

    • Recognise the early warning signs of a leak or bleed after bariatric surgery
    • Manage a staple-line leak after sleeve gastrectomy with endoscopic and surgical options
    • Diagnose internal hernia after gastric bypass and operate without delay
    • Stabilise and refer a patient who had bariatric surgery abroad

  5. 20. Late complications, nutrition and revisional surgery

    • Apply micronutrient monitoring and replacement after bariatric surgery
    • Diagnose and treat marginal ulcer, dumping and post-bariatric hypoglycaemia
    • Assess weight recurrence and decide between medical and revisional treatment
    • Advise on contraception, pregnancy and alcohol after bariatric surgery
Module 5 · Sessions 21 to 25Wider practice and professional standards

  1. 21. Endoscopic bariatric therapies and obesity medicines for the surgeon

    • Select patients for endoscopic sleeve gastroplasty or an intragastric balloon
    • Explain the weight loss evidence for endoscopic therapies and obesity medicines
    • Plan the use of obesity medicines before or after surgery
    • Identify where UK funding and US practice differ

  2. 22. Nutrition and prehabilitation in upper GI surgery

    • Screen patients for malnutrition before major upper GI surgery
    • Plan a prehabilitation programme for a patient awaiting oesophagectomy
    • Choose an enteral feeding route after major upper GI surgery
    • Prevent and manage refeeding syndrome

  3. 23. Quality, audit and new technology

    • Use national audit and registry data to benchmark a unit's outcomes
    • Explain why oesophagogastric and pancreatic cancer surgery is centralised
    • Introduce a new procedure, such as robotic surgery, through local governance and NICE guidance
    • Submit complete outcome data to a national registry

  4. 24. Consent and shared decisions in high-risk upper GI and bariatric surgery

    • Explain the material risks of oesophagectomy, pancreatoduodenectomy and bariatric surgery in plain language
    • Use a decision aid to support a shared decision
    • Agree ceilings of care with a patient who has incurable upper GI cancer
    • Communicate about weight without stigma

  5. 25. Complex case review and professional practice

    • Apply the course to complex upper GI and bariatric cases in a panel discussion
    • Present a complication at a morbidity and mortality meeting to drive learning
    • Fulfil the professional duty of candour after harm
    • Plan your own development towards a specialist upper GI, HPB or bariatric practice

What the diploma includes

  • 25 live sessions on Zoom, one evening a week, with recordings for the weeks you miss.
  • Practising specialists teaching live, so you can put your questions to them.
  • Weekly MCQs and a final written assessment.
  • A digital certificate carrying your final classification.

Lead or teach the Upper GI and Bariatric Surgery Diploma

We are looking for a course director and faculty from the specialty. Sessions are one hour in the UK evening, live on Zoom, and paid.

Apply to teach