Background Operative reports (OR) are critical documents in the medical record but are often poor quality. Synoptic reporting (SR) is a potential solution. This has never been assessed in bariatric surgery. The objective was to design and trial a SR for Roux en Y gastric bypass (RYGB), a common bariatric procedure.

Methods Systematic review and meta-analysis of comparative studies on SR and narrative reporting (NR) was conducted. A Delphi group developed quality indicators (QIs) for RYGB OR based on these findings. A national needs assessment and audit was then performed and a RYGB SR was subsequently designed and prospectively trailed against NRs.

Results Meta-analysis found SRs more complete and efficient than NRs. Seventy-five QIs were established and found bariatric ORs of mediocre quality. RYGB SR was more complete for all items compared to NRs (>99% vs 64%).

Conclusion SR for RYGB is superior to NR and should be implemented into clinical practice across Canada.