The Impact of the COVID-19 Pandemic on Bariatric Surgery: Results from a Worldwide Survey

Abstract

Background The ongoing "coronavirus disease 19" (COVID-19) pandemic has had a strong effect on the delivery of surgical care worldwide. Elective surgeries have been canceled or delayed in order to reallocate resources to the treatment of COVID-19 patients. Currently, the impact of the COVID-19 pandemic on bariatric and metabolic surgical practice remains unclear. Methods An internet-based online survey was performed among bariatric surgeons worldwide. The survey was sent to bariatric surgeons via the International Bariatric Club Facebook group and by electronic mail via the International Federation for the Surgery of Obesity and metabolic disorders (IFSO) secretariat to members of the associated national IFSO societies. Results One hundred sixty-nine (n = 169) bariatric surgeons participated in the survey. The majority of the respondents postponed preoperative upper gastrointestinal tract endoscopies, appointments in the outpatient clinic and bariatric operations. Most surgeons performed video calls for follow-up appointments instead of meeting the patients in the outpatient clinics. Laparoscopy was still the preferred treatment for surgical emergencies, but a trend towards conservative treatment of acute appendicitis and acute cholecystitis was shown. Rapid preoperative COVID-19 testing availability was poor; therefore, routine screening of emergency bariatric cases was not widely provided. A wide variance occurred regarding precautions and personal protection equipment among the participants. Conclusion The COVID-19 pandemic showed a strong impact on bariatric surgical practice regarding surgical and outpatient planning as well as personnel management. Coordinated effort from the national bariatric societies should focus on strict implementation of the current recommendations regarding precaution measures and personal protection equipment. Further studies should evaluate how this impact will evolve in the near future.

Factors Related to Weight Gain in Subjects with Sleeve Gastrectomy During Lockdown by the COVID-19 Pandemic

“…Traditional consultations consisted of 15–20-min face-to-face consultations with a prior blood test and face-to-face anthropometry of the patient; however, telephone visits involve questionnaires like the one used, without blood tests and with anthropometric data self-reported by the patients. Bariatric surgery has been inevitably affected by the COVID-19 pandemic, as indicated by Lazaridis et al [ 11 ] in a worldwide survey. In our study, we have detected how a 49.3% of patients did not attend their visit in the Nutrition Unit and this was related to weight gain.…”

Bariatric surgery in patients with previous COVID-19 infection

“…The majority of patients have struggled for many years with noninvasive measures like diet, exercise, and pharmacotherapy before surgery. The current COVID-19 pandemic, with its high morbidity and mortality, has led to the cancellation of millions of surgeries, including all bariatric surgery procedures [ 10 , 11 ]. Many centers were afraid to resume activity due to the risk of contamination for patients with morbid obesity or additional deterioration of their pulmonary function.…”

Role of bariatric surgery in a COVID-19 era: a review of economic costs

“…The reduction of face-to-face clinical care has also impacted on the care of chronic diseases such as hypertension and diabetes, which will likely have associated long-term costs, especially in obese patients. A world-wide survey among bariatric surgeons found that 84.6% of surgeons had postponed primary or redo bariatric procedures in light of the COVID-19 pandemic 28 . A J o u r n a l P r e -p r o o f similar survey in the UK found that 97% of bariatric surgeons ceased their outpatient clinics for both new and follow-up patients and almost 60% of bariatric surgeons stopped placing new patients on their waiting lists 29 .…”