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1.
Obesity Science & Practice ; 2023.
Article in English | Web of Science | ID: covidwho-2308709

ABSTRACT

BackgroundThe first year of the Covid-19 pandemic saw drastic changes to bariatric surgical practice, including postponement of procedures, altered patient care and impacting on the role of bariatric surgeons. The consequences of this both personally and professionally amongst bariatric surgeons has not as yet been explored. AimsThe aim of this research was to understand bariatric surgeons' perspectives of working during the first year of the pandemic to explore the self-reported personal and professional impact. MethodsUsing a retrospective, two phased, study design with global participants recruited from closed, bariatric surgical units. The first phase used a qualitative thematic analytic framework to identify salient areas of importance to surgeons. Themes informed the construction of an on-line, confidential survey to test the potential generalizability of the interview findings with a larger representative population from the global bariatric surgical community. FindingsFindings of the study revealed that the first year of the pandemic had a detrimental effect on bariatric surgeons both personally and professionally globally. ConclusionThis study has identified the need to build resilience of bariatric surgeons so that the practice of self-care and the encouragement of help-seeking behaviors can potentially be normalized, which will in turn increase levels of mental health and wellbeing.

2.
British Journal of Surgery ; 109(Supplement 9):ix3, 2022.
Article in English | EMBASE | ID: covidwho-2188318

ABSTRACT

Background: The availability and popularity of bariatric and metabolic surgery (BMS) continues to increase worldwide and in turn so do the resources allocated to it. The last NBSR report (2020) demonstrated that 70% of patients were discharged on the second postoperative day and 80% left after the third day. An amended protocol was implemented within our Trust switching from a 2-3 night stay and reducing this to a planned one-night stay for a more efficient service. This review evaluates the safety and efficacy of a one-night stay protocol. Method(s): All patients undergoing BMS between two sets of dates were retrospectively identified from our local database, pre and post protocol change. Group A (old protocol, July-December '19) and Group B (one-night stay protocol, July '20-July '21). Group B capture time was extended due to smaller numbers due to COVID. Data gathered included: Patient demographics (Age, Gender, ASA, Weight, BMI);operation;length of stay (LOS);30-day complications, 30-day mortality, and 30-day readmission rates. Descriptive statistics and Chi-squared test were used to analyse results. Result(s): Group A had 94 patient and Group B 149 patients. Patient demographics, weight and ASA were similar in both groups. There were significantly more RYGB in Group A whilst more OAGBs and sleeves in Group B: RYGB;(48[51%] vs. 30[20%]), OAGB;(32[34%] vs. 80[53%]), Sleeve;(13[14%] vs. 36[24%]). Median LOS reduced from 3 days to 1 day and mean LOS 3.2 days to 1.3 days. In Group B, 115 patients (77%) were discharged on post-operative day 1 vs. 18 (19%) in Group A. In the 34 (23%) of patients that required stay beyond day 1 in Group B the most common reason was post-operative nausea and vomiting (n=8). Other frequent reasons were pain (n=5), low urine output/AKI (n=5) and not tolerating oral diet (n=4). There were no statistically significant differences between groups for 30-day complication (6[6%] vs. 5[3%] p=0.4) or re-admission (4[4%] vs. 8[5%] p=0.9) rates. In sub-group analysis, there was no difference between operation type and LOS/complication rates. In a review of the readmissions, it was not felt any were avoidable and only 1/8 readmissions were within 48h of discharge - this patient already had an extended admission. Conclusion(s): This study demonstrated that a planned one-night stay following BMS is both safe and effective;facilitating early patient discharges whilst having the necessary safety netting steps for those who require a require an extended period in hospital. The next step would be to explore the safety of day case surgery for selected patients undergoing sleeve gastrectomy.

3.
Obesity Science and Practice. ; 2022.
Article in English | EMBASE | ID: covidwho-2173330

ABSTRACT

Background: The first year of the Covid-19 pandemic saw drastic changes to bariatric surgical practice, including postponement of procedures, altered patient care and impacting on the role of bariatric surgeons. The consequences of this both personally and professionally amongst bariatric surgeons has not as yet been explored. Aim(s): The aim of this research was to understand bariatric surgeons' perspectives of working during the first year of the pandemic to explore the self-reported personal and professional impact. Method(s): Using a retrospective, two phased, study design with global participants recruited from closed, bariatric surgical units. The first phase used a qualitative thematic analytic framework to identify salient areas of importance to surgeons. Themes informed the construction of an on-line, confidential survey to test the potential generalizability of the interview findings with a larger representative population from the global bariatric surgical community. Finding(s): Findings of the study revealed that the first year of the pandemic had a detrimental effect on bariatric surgeons both personally and professionally globally. Conclusion(s): This study has identified the need to build resilience of bariatric surgeons so that the practice of self-care and the encouragement of help-seeking behaviors can potentially be normalized, which will in turn increase levels of mental health and wellbeing. Copyright © 2022 The Authors. Obesity Science & Practice published by World Obesity and The Obesity Society and John Wiley & Sons Ltd.

4.
British Journal of Surgery ; 109(Supplement 5):v9, 2022.
Article in English | EMBASE | ID: covidwho-2134956

ABSTRACT

Background: The progressive growth of The older patients with obesity represents a challenge to The weight management teams. Although initially, old age was a relative contraindication to The surgical option, current advances in laparoscopic techniques and perioperative optimization protocols have changed The old notion. However, The performance of bariatric procedures in The older patients during The ongoing CoVID-19 pandemic carries a potential risk. This study aimed to assess The safety of bariatric surgery (BS) in older patients during The pandemic. Method(s): We conducted a prospective international study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into two groups-older patients >65-year-old (group I) and young < 65-year-old (group II). Two groups were compared for 30-day morbidity and mortality. Result(s): We included 7084 patients, The mean age was 40.35+/-11.9 years, and 5197 (73.4%) were females. The mean preoperative weight and BMI were 119.49+/-24.4 Kgs and 43.03+/-6.9 Kg/m2, respectively. The overall comorbidities were significantly higher in group I, p= <0.001. In group II, 14.8% were current smokers, compared to 7.4% of group I. The complications in group I were significantly higher (11.4%) compared to group II (6.6%), p= 0.022. However, The mortality rate and CoVID-19 infection within 30 days were not significantly different between The two groups. Conclusion(s): Bariatric surgery during The CoVID-19 pandemic in The older patients (>65 years old) is associated with a higher complication rate than The younger age group. However, The mortality and postoperative CoVID-19 infection rates are comparable to The younger age group.

5.
British Journal of Surgery ; 108(SUPPL 7):vii180, 2021.
Article in English | EMBASE | ID: covidwho-1585078

ABSTRACT

The infection control measures implemented as a result of COVID-19 led to a postponement of bariatric surgical procedures across many countries worldwide. Many bariatric surgical teams were in essence left without a profession, with many redeployed to other areas of clinical care and were not able to provide the levels of patient support given before COVID-19. As the pandemic continues, some restrictions have been lifted, with staff adjusting to new ways of working, incorporating challenging working conditions and dealing with continuing levels of stress. This article explores the concept of emotional labour, defined as 'inducing or suppressing feelings in order to perform one's work', and its application to multidisciplinary teams working within bariatric surgery, to offer insight into the mental health issues that may be affecting healthcare professionals working in this discipline.

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