The aim of the study was to define an appropriate time to resume bariatric surgery after the end of the SARS-COV-2 pandemic.
The study was conducted in two groups: Group 1 – bariatric patients, Group 2 – bariatric surgeons. Two anonymous online surveys were designed. Surgeons from four bariatric centers were responsible for distribution of survey and gathering of material. The first survey was prepared for patients from the Polish Association of Bariatric Patients (CHLO) and distributed online among patients. The second survey was sent to all bariatric surgeons associated with the Metabolic and Bariatric Chapter at the Association of Polish Surgeons (SCMiB) who were invited to take part in the study by recruiting surgeons via e-mail through the SCMiB mailing list. An invitation to the project was also published on the official SCMiB website. The surveys were conducted between 8 and 22 April. The invitation to the project and the introduction to the questionnaire give details of the study design, assumptions of the study and types of questions. At the beginning of the survey, detailed technical instructions were issued on how to complete the form. Participation in both surveys was voluntary. Participants were required to give their consent to participate in the study as their response to the first survey question, which also supplied information on how to withdraw consent.
Inclusion and exclusion criteria
Group 1 included patients who were members of CHLO and who answered all the questions in the survey. The group contained patients before and after surgery. Cancer patients or patients with complications after bariatric interventions whose surgery could not be postponed were advised not to complete the questionnaire. Group 2 included surgeons and general surgery residents who are members of SCMiB working in bariatric centers. Both certified and non-certified bariatric surgeons were included in the study. Retired surgeons, surgeons who were not performing bariatric procedures and medical doctors who are not practicing medicine during the pandemic (because of sick leave or vacation) were excluded.
Questionnaires for both study groups were accessible online. There was no time limitation on completion. Both surveys were divided into two parts.
The first part consisted of questions covering consent to participate and basic demographic data characterizing the groups of patients and surgeons. The group of patients was asked to state their age, sex, current body mass index (BMI), obesity comorbidites, whether they had undergone bariatric procedures in the past, contact with COVID+/quarantined persons and COVID status of the hospital taking care of them. Questions to the surgeon group concerned age, sex, stage of surgical training, type of employing hospital, COVID status of employing hospital and number of bariatric procedures performed in 2019 and 2020 until the start of the pandemic.
The second part included the same questions in both surveys. The patient group and surgeon group were first asked when bariatric surgery should be resumed. In view of the lengthening waiting list for other elective procedures, especially oncological operations, both surveys then asked for the respondent’s opinion on how to reconcile the waiting lists for bariatric procedures with those for other elective surgery, including oncological procedures (Fig. 1).
Results were presented as mean plus standard deviation or median with interquartile range. To assess factors that could potentially influence the responses provided, univariate and multivariate regression models were run on Statistica 13.5 PL (Statsoft, USA).