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unparalleled metabolic benefits, but those benefits come with life-long risks that must be managed
with the same scientific rigor that he brought to every aspect of his work. His legacy is not a perfect
operation – no such thing exists – but a method: to innovate boldly, to measure meticulously, to
report honestly, and to let the data speak, even when the truth is difficult.

Enduring Influence
Nicola Scopinaro died on the night of 28 October 2020, in Genoa. He left behind more than 3500
operated patients, over 500 scientific publications, more than 700 invited lectures, and a generation
of surgeons trained in his methods [5]. He was the founder and Honorary President of the Italian
Society of Obesity Surgery (SICOB), of IFSO, and of the IFSO European Chapter. He was
Co-Editor-in-Chief of Obesity Surgery, the official journal of IFSO.

His greatest legacy is the intellectual framework he gave us: that obesity is a disease, not a moral
failing; that effective treatment requires an interdisciplinary approach; that surgery can be both
powerful and safe when based on rigorous physiology; that a surgeon can be a scientist, an athlete,
a pilot, an epicurean, and a kind friend, all at once; and that the truth, however uncomfortable, must
always be pursued and honored.
Edward Mason, Nicola Scopinaro, and Henry Buchwald are rightly called the three pioneers of MBS.
But for those of us who knew him, Scopinaro was more than a pioneer. He was il nostro maestro - our
teacher and our model.

Acknowledgements: The author thanks Manuela Mazzarella of IFSO for coordinating this chapter,
and all the colleagues who shared their memories of Professor Scopinaro.

References

1. Scopinaro N, Gianetta E, Civalleri D, Bonalumi U, Bachi V. Bilio-pancreatic bypass for obesity: II.
Initial experience in man. Br J Surg. 1979;66(9):618-620.
2. Scopinaro N, Gianetta E, Adami GF, et al. Biliopancreatic diversion for obesity at eighteen
years. Surgery. 1996;119(3):261-268.

3. Scopinaro N, Adami GF, Papadia FS, et al. Effects of biliopancreatic diversion on type 2
diabetes in patients with BMI 25 to 35. Ann Surg. 2011;253(4):699-703.

4. Papadia FS, Adami GF, Roscelli C, Cassano M, De Cian O. Biliopancreatic diversion for severe
obesity: a 50-year cohort study on survival, weight loss, control of metabolic comorbidities,
nutritional morbidity, and late revisions. Ann Surg. 2026 May 8. doi:
10.1097/SLA.0000000000007087. Epub ahead of print.
5. Buchwald H. Nicola Scopinaro: A Celebration of His Life. Obes Surg. 2021;31(3):911-912.

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