Consideration of laparoscopic metabolic and bariatric surgery during COVID-19 pandemic

Abstract

: COVID-19 pandemic has severely challenged the healthcare resources and impacted the medical practice globally. In most of the nations involved, non-urgent, non-cancer procedures have been suspended to reallocate medical and paramedical staff to combating the pandemic and emergency cases. Laparoscopic metabolic and bariatric surgery (LMBS) was traditionally classified as elective procedures, therefore, a great number of hospitals have postponed or even cancelled such procedures during the outbreak of COVID-19. In addition, many of the bariatric surgery candidate patients are also worried about acquired infection if staying in the hospital. However, since the pandemic is predicted to be last for a relatively longer time as we expected, we have no reason not to resume elective procedures if resources are allowed. This paper focuses particularly on the impacts of COVID-19 pandemic on LMBS and when and how to resume it orderly. A special caution protocol should be developed and implemented when caring patients in order to minimize or even prevent the virus transmitting and spreading inside healthcare facility. The protocol includes triage and prioritization of patients, screening, protections in the inpatient ward, in the operating theater, and after surgery. The goal of enforcing these protocols is to help restarting our practice during the “new normal” era. The core principles of this protocol can also be applied to any surgical specialties.