Safety and feasibility of resuming bariatric surgery under the cloud of COVID-19

• Published in: Annals of the Royal College of Surgeons of England 2021-07, Vol.103 (7), p.524-529
• Main Authors: Mamidanna, R, Askari, A, Patel, K, Adil, M T, Jain, V, Jambulingam, P, Whitelaw, D, Rashid, F, Munasinghe, A, Al-Taan, O
• Format: Article
• Language: English
• Subjects: Adult; Bariatric Surgery; Bariatric Surgery - adverse effects; Bariatric Surgery - standards; Bariatric Surgery - statistics & numerical data; Blood pressure; Clinical Protocols - standards; Communicable Disease Control - organization & administration; Communicable Disease Control - standards; Coronaviruses; COVID-19; COVID-19 - diagnosis; COVID-19 - epidemiology; COVID-19 - prevention & control; COVID-19 - transmission; COVID-19 Testing - standards; COVID-19 Testing - statistics & numerical data; Diet; Disease transmission; Elective surgery; Elective Surgical Procedures - adverse effects; Elective Surgical Procedures - standards; Elective Surgical Procedures - statistics & numerical data; Enhanced Recovery After Surgery - standards; Feasibility Studies; Female; Gastrointestinal surgery; Hospitals; Humans; Laparoscopy; Length of Stay - statistics & numerical data; Male; Metabolism; Middle Aged; Molecular weight; Obesity; Obesity, Morbid - complications; Obesity, Morbid - surgery; Pandemics; Pandemics - prevention & control; Patient Readmission - statistics & numerical data; Patients; Personal protective equipment; Polymerase chain reaction; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Prospective Studies; Retrospective Studies; Risk Assessment - statistics & numerical data; SARS-CoV-2 - isolation & purification; Severe acute respiratory syndrome coronavirus 2; Surgery Department, Hospital - organization & administration; Surgery Department, Hospital - standards; Surgery Department, Hospital - statistics & numerical data
• ISSN: 0035-8843; 1478-7083
• DOI: 10.1308/rcsann.2021.0053

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. 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. 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/m . Half of the patients ( = 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. 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.