Developing a New Tool for Determining the Difficulty of Laparoscopic Bariatric Surgery

Abstract

Background: Recommendations for candidates of bariatric surgery are available but they seldom give guidance to help a specific patient. The purpose of this study is to develop a new tool for determining the difficulty of laparoscopic bariatric surgery before surgery. Methods: This was a mixed method study. After a comprehensive search, semi structure interview and focus group discussions (FGD) with surgeons, and operating room personnel and department, initial draft of the questionnaire was prepared. We used Delphi method to achieve a group consensus of national and international surgeons. Finally, after several times of review and modification of the designed questions, a final questionnaire was prepared. Content and face validity, reliability and internal consistency (using Cronbach’s alpha) were determined.Results: Final questionnaire has 31 questions consist of I. Factors related to surgeon: experience(four questions), and exposure(one question), II. Factors related to patient: anatomy(eleven questions), and comorbidities(two questions), patient’s position(one question), and others(one question), III. Factors related to instruments and operation room, quantity(two questions), and quality(one question), IV. Factors related to other personnel: anesthesia team(six questions), and other personnel(two questions). Cronbach’s alpha was 0.98 for the whole questionnaire and between 0.86 and 0.97 for the four subscales. Conclusions: The psychometrics analysis indicated that it is valid and reliable for determining the difficulty of laparoscopic bariatric surgery. We recommend using this questionnaire for different settings either need to know difficulty of a bariatric surgery before a surgery or as an independent variable in various research projects.