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Practice Guideline
. 2020 Aug;157(4):317-327.
doi: 10.1016/j.jviscsurg.2020.06.005. Epub 2020 Jun 5.

SOFFCO-MM guidelines for the resumption of bariatric and metabolic surgery during and after the Covid-19 pandemic

R Kassir  1 , L Rebibo  2 , L Genser  3 , A Sterkers  4 , M-C Blanchet  5 , F Pattou  6 , S Msika  7 ; Remerciement comité de lecture
Collaborators, Affiliations
Practice Guideline

SOFFCO-MM guidelines for the resumption of bariatric and metabolic surgery during and after the Covid-19 pandemic

R Kassir et al. J Visc Surg. 2020 Aug.

Abstract

Bariatric/metabolic surgery was paused during the Covid-19 pandemic. The impact of social confinement and the interruption of this surgery on the population with obesity has been underestimated, with weight gain and worsened comorbidities. Some candidates for this surgery are exposed to a high risk of mortality linked to the pandemic. Obesity and diabetes are two major risk factors for severe forms of Covid-19. The only currently effective treatment for obesity is metabolic surgery, which confers prompt, lasting benefits. It is thus necessary to resume such surgery. To ensure that this resumption is both gradual and well-founded, we have devised a priority ranking plan. The flow charts we propose will help centres to identify priority patients according to a benefit/risk assessment. Diabetes holds a central place in the decision tree. Resumption patterns will vary from one centre to another according to human, physical and medical resources, and will need adjustment as the epidemic unfolds. Specific informed consent will be required. Screening of patients with obesity should be considered, based on available knowledge. If Covid-19 is suspected, surgery must be postponed. Emphasis must be placed on infection control measures to protect patients and healthcare professionals. Confinement is strongly advocated for patients for the first month post-operatively. Patient follow-up should preferably be by teleconsultation.

Keywords: Bariatric surgery; Covid-19; Guidelines; Obesity; Pandemic.

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Figures

Figure 1
Figure 1
Benefits of weight-loss surgery by category during the Covid-19 crisis.
Figure 2
Figure 2
Risks of morbidity in weight-loss surgery by category during the Covid-19 crisis.
Figure 3
Figure 3
Categories of patients undergoing primary weight-loss surgery in the current Covid-19 setting. BRR: benefit/risk ratio.
Figure 4
Figure 4
Resumption of overall activity according to the evolution of the Covid-19 pandemic.
Figure 5
Figure 5
Preoperative measures before scheduled surgery.
See this image and copyright information in PMC

References

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