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Ann R Coll Surg Engl ; 103(7): 524-529, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1288677


INTRODUCTION: Because of the COVID-19 pandemic, numerous bariatric surgical units globally have halted weight loss surgery. Obesity itself has been shown to be a predictor of poor outcome in people infected with the virus. The aim of this study was to report our experience as a high-volume bariatric institution resuming elective weight loss surgery safely amidst emergency admissions of COVID-19-positive patients. METHODS: A standard operating procedure based on national guidance and altered to accommodate local considerations was initiated across the hospital. Data were collected prospectively for 50 consecutive patients undergoing bariatric surgery following recommencement of elective surgery after the first national lockdown in the UK. RESULTS: Between 28 June and 5 August 2020, a total of 50 patients underwent bariatric surgery of whom 94% were female. Median age was 41 years and median body mass index was 43.8 (interquartile range 40.0-48.8)kg/m2. Half of the patients (n = 25/50) underwent laparoscopic sleeve gastrectomy and half underwent Roux-en-Y gastric bypass (RYGB). Of these 50 patients, 9 (18%) had revisional bariatric surgery. Overall median length of hospital stay was 1 day, with 96% of the study population being discharged within 24h of surgery. The overall rate of readmission was 6% and one patient (2%) returned to theatre with an obstruction proximal to jejuno-jejunal anastomosis. None of the patients exhibited symptoms or tested positive for COVID-19. CONCLUSION: With appropriately implemented measures and precautions, resumption of bariatric surgery during the COVID-19 pandemic appears feasible and safe with no increased risk to patients.

Bariatric Surgery/adverse effects , COVID-19/prevention & control , Elective Surgical Procedures/adverse effects , Obesity, Morbid/surgery , Postoperative Complications/epidemiology , Adult , Bariatric Surgery/standards , Bariatric Surgery/statistics & numerical data , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/transmission , COVID-19 Testing/standards , COVID-19 Testing/statistics & numerical data , Clinical Protocols/standards , Communicable Disease Control/organization & administration , Communicable Disease Control/standards , Elective Surgical Procedures/standards , Elective Surgical Procedures/statistics & numerical data , Enhanced Recovery After Surgery/standards , Feasibility Studies , Female , Humans , Length of Stay/statistics & numerical data , Male , Middle Aged , Obesity, Morbid/complications , Pandemics/prevention & control , Patient Readmission/statistics & numerical data , Postoperative Complications/etiology , Prospective Studies , Retrospective Studies , Risk Assessment/statistics & numerical data , SARS-CoV-2/isolation & purification , Surgery Department, Hospital/organization & administration , Surgery Department, Hospital/standards , Surgery Department, Hospital/statistics & numerical data
Cir Esp (Engl Ed) ; 99(1): 4-10, 2021 Jan.
Article in English, Spanish | MEDLINE | ID: covidwho-758678


The SARS-CoV-2 pandemic has a great impact worldwide, being Spain one of the most affected countries. The delay in bariatric surgery can have fatal consequences since up to 50% of the patients who are on the waiting list develop a new comorbidity during the time they remain on it and 1.5% of patients die while waiting for the intervention. That is why bariatric surgery should not be delayed, if the occupation of the hospital by COVID-19+ patients decreases significantly, and sufficient resources and safety are available to restart surgery in patients with benign pathology. This document contains the main recommendations for the bariatric surgery programs in our country from the point of view of safety, bariatric patient preparation and follow up during the SARS-CoV-2 pandemia.

Bariatric Surgery/standards , COVID-19/epidemiology , Obesity/surgery , Pandemics , Practice Guidelines as Topic , Comorbidity , Humans , Obesity/epidemiology , SARS-CoV-2
Obes Surg ; 30(12): 5101-5107, 2020 12.
Article in English | MEDLINE | ID: covidwho-724069


Bariatric and metabolic surgery (BMS), the only effective option for patients with obesity with or without comorbidities, has been stopped temporarily due to the ongoing novel corona virus disease (COVID-19) pandemic. However, there has been a recent change in the governmental strategy of dealing with this virus from 'Stay at Home' to 'Stay Alert' in many countries including India. A host of health services including elective surgeries are being resumed. In view of the possibility of resumption of BMS in near future, Obesity and Metabolic Surgery Society of India (OSSI) constituted a committee of experienced surgeons to give recommendations about the requirements as well as precautions to be taken to restart BMS with emphasis on safe delivery and high-quality care.

Bariatric Surgery/standards , COVID-19/epidemiology , Pandemics , Societies, Medical , COVID-19/prevention & control , COVID-19/transmission , COVID-19 Testing , Diagnostic Imaging , Humans , India/epidemiology , Infection Control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Informed Consent , Operating Rooms/organization & administration , Patient Discharge , Patient Selection , Personal Protective Equipment , Postoperative Care , Preoperative Care
Rev. Col. Bras. Cir ; 47: e20202640, 2020.
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-634426


ABSTRACT Prioritizing surgical procedures aims at facilitating patient's access according to the clinical needs, maximizing access equity, and minimizing the damage from delayed access. Previous categorization of elective bariatric surgery have been adapted to define an objective prioritizing system that reflects those principles for bariatric and metabolic operations. Given the factors that contribute to the morbidity and mortality of obese and type 2 diabetes patients, surgical prioritization should be based on clinical risk stratification. For patients with type 2 diabetes, we suggest that the operation may be prioritized for those with a higher risk of morbidity and mortality in a relatively short term. Likewise, it is necessary to guide the surgical team regarding the necessary care both in the pre, per and postoperative periods of bariatric and metabolic surgery. These recommendations aim to reduce the risk of in-hospital contamination of the surgical team among health professionals and between health professionals and patients. In summary, these recommendations have been shaped after a thorough analysis of the available literature and are extremely important to mitigate the harm related to the clinical complications of obesity and its comorbidities while keeping healthcare providers' and patients' safety.

RESUMO A priorização de qualquer operação eletiva visa facilitar o acesso do paciente de acordo com as necessidades clínicas, maximizando a equidade de acesso e minimizando os danos causados pelo atraso. As categorias de operações eletivas foram adaptadas para definir sistema de priorização objetiva que reflete esses princípios para operações bariátricas e metabólicas. Em razão dos fatores que contribuem para a morbidade e mortalidade da obesidade e do diabetes tipo 2, a priorização cirúrgica deve ser baseada na estratificação de risco clínico. Para pacientes com diabetes tipo 2, sugerimos que a operação possa ser priorizada para aqueles com maior risco de morbidade e mortalidade, em prazo relativamente curto. Da mesma forma, é necessário orientar a equipe cirúrgica quanto aos cuidados necessários tanto no pré, per e pós-operatório da cirurgia bariátrica e metabólica. As recomendações visam reduzir o risco de contágio hospitalar da equipe cirúrgica tanto entre profissionais de saúde quanto entre profissionais de saúde e pacientes. Em resumo, estas recomendações foram moldadas após análise minuciosa da literatura disponível e são extremamente importantes para mitigar os danos das complicações clínicas, sensíveis a doença obesidade e comorbidades, mantendo a segurança dos profissionais de saúde e dos pacientes.

Humans , Pneumonia, Viral/prevention & control , Obesity, Morbid/surgery , Elective Surgical Procedures/standards , Coronavirus Infections/prevention & control , Bariatric Surgery/standards , Pandemics/prevention & control , Betacoronavirus , Obesity, Morbid/complications , Brazil , Guidelines as Topic , Diabetes Mellitus, Type 2/complications , SARS-CoV-2 , COVID-19 , Health Priorities
Updates Surg ; 72(2): 259-268, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-574895


The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its related disease, coronavirus disease 2019 (COVID-19), has been rapidly spreading all over the world and is responsible for the current pandemic. The current pandemic has found the Italian national health system unprepared to provide an appropriate and prompt response, heavily affecting surgical activities. Based on the limited data available in the literature and personal experiences, the Società Italiana di Chirurgia dell'OBesità e Malattie Metaboliche (SICOB) provides recommendations regarding the triage of bariatric surgical procedures during the COVID-19 pandemic defining a dedicated path for surgery in morbidly obese patients with known or suspected COVID-19 who may require emergency operations. Finally, the current paper delineates a strategy to resume outpatient visits and elective bariatric surgery once the acute phase of the pandemic is over. Models developed during the COVID-19 crisis should be integrated into hospital practices for future use in similar scenarios. Surgeons are presented with a golden opportunity to embrace systemic change and to drive their professional future.

Bariatric Surgery , Coronavirus Infections , Elective Surgical Procedures , Obesity/surgery , Pandemics , Pneumonia, Viral , Quarantine , Bariatric Surgery/methods , Bariatric Surgery/standards , COVID-19 , Decision Trees , Disease Outbreaks , Humans , Time Factors