ABSTRACT
BACKGROUND: Patients living with obesity continue to experience body image dissatisfaction following bariatric metabolic surgery. The underlying reasons are poorly understood but may be due to unmet expectations. Negative body image perception following metabolic surgery leads to poorer psychological and clinical outcomes. This study aims to establish the acceptability and feasibility of three-dimensional (3D) reconstruction and virtual reality (VR) as a method of providing psychological support to bariatric patients to improve body image satisfaction and interventional outcomes. METHODS: Seven participants were recruited from the Imperial Weight Centre. 3D photographs were captured and processed to produce two 3D reconstructed images with 15% and 25% total weight loss. Participants were shown their images using VR and participated in peer group workshops. RESULTS: Six participants were retained until the end of the study. Five out of six participants agreed the images provided them with a more accurate representation of their body changes and overall appearance following bariatric metabolic surgery. All participants strongly agreed with the group setting and felt VR facilitated discussions on body image. Overall, all participants felt that the use of VR and 3D reconstruction is beneficial in supporting patients to adjust to changes in their body image after bariatric metabolic surgery. CONCLUSIONS: This is the first study to explore and demonstrate that 3D reconstruction and VR is an acceptable and feasible method providing patients with a realistic expectation of how their body will change following significant weight loss, potentially improving body image satisfaction after surgery, as well as psychological and interventional outcomes.
Subject(s)
Bariatric Surgery , Body Image , Feasibility Studies , Imaging, Three-Dimensional , Obesity, Morbid , Virtual Reality , Humans , Body Image/psychology , Female , Bariatric Surgery/psychology , Bariatric Surgery/methods , Male , Adult , Obesity, Morbid/surgery , Obesity, Morbid/psychology , Middle Aged , Patient Satisfaction , Weight LossABSTRACT
A 61-year-old man presented with non-specific abdominal symptoms, including left groin pain and change in bowel habits. Investigations revealed a cystic lesion, containing numerous irregular calcifications, with the primary differential being a dermoid cyst containing teeth-like calcifications. At laparoscopy it was found to be a Meckel's diverticulum, containing a large number of enteroliths. This case revealed the importance of considering enteroliths in patients with imaging showing intra-abdominal calcifications, and laparoscopy for diagnosis and treatment.
Subject(s)
Calculi/complications , Calculi/diagnostic imaging , Meckel Diverticulum/complications , Meckel Diverticulum/diagnostic imaging , Calculi/surgery , Diagnosis, Differential , Humans , Magnetic Resonance Imaging/methods , Male , Meckel Diverticulum/surgery , Middle Aged , Tomography, X-Ray Computed/methodsABSTRACT
The COVID-19 pandemic of 2020 has greatly impacted healthcare systems and society more generally around the world. The management of patients infected with SARS-CoV-2 has primarily impacted emergency departments, medical teams, and intensive care units. However, the impact on health systems as a whole, including surgical specialties, has been wide ranging. We aimed to establish the impact of the COVID-19 pandemic and associated lockdown on the number and characteristics of general surgical patients reviewed and/or admitted by the surgical team within a district general hospital. We performed a retrospective cohort analysis of patients admitted in the 2-week period from start of the lockdown (Monday 23rd March 2020 to 5th April 2020), and the same period 1 year earlier (Monday 25th March 2019 to 7th April 2019). Number of patients reviewed and admitted were compared between the two cohorts. Data including diagnosis, operation/procedural interventions, and length of stay were analysed. The overall number of patients reviewed and admitted by the surgical team was substantially lower during the period of lockdown (61 vs 126). Of the patients seen during lockdown, a smaller proportion were admitted to hospital after initial surgical review (59% vs 77%, p < 0.05). Interventional/operative procedures were performed in a similar proportion of patients in both cohorts (31%). Our data show that there has been a substantial reduction in the number of patients being referred to and admitted by the general surgical team at our centre during the COVID-19 pandemic. Explanations for this include reduced attendance due to risk perception of the patients, the impact of lockdown messages and advice regarding self-isolation, as well as an increased threshold for patient admission during the COVID-19 pandemic. Key learning points include the possible benefits of a reduction in admission to hospital of patients with nonurgent conditions.
