Bariatric Times

MAR 2018

A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional

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Original Research 17 Bariatric Times • March 2018 The survey skipped to the next section if a respondent indicated no pain experienced in any body region. If they answered positively, however, further questions followed. These included questions about interference with work, difficulties, and characterization of the difficulty (pain, stiffness, weakness, paresthesia, or other), severity (scale of 0–10), whether the symptoms stopped the surgeon from operating, and whether the surgeon attributed their symptoms to their work. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. Statistical analysis. The study was conducted anonymously between May 2017 and August 2017, receiving responses from 113 bariatric surgeons from around the world. Descriptive statistics were analyzed using SPSS software version 22. The significance of the difference between the two values was analyzed using a two-tailed unpaired Student's t-test. Significant levels were assessed at p-value <0.05. RESULTS A total of 113 bariatric surgeons from 34 countries completed the survey during the period of data collection, with the majority (15.9%) being from Kuwait. Of the respondents, 94.7 percent were men, with an average age of 45.2 years. The rest of the demographics are summarized in Table 1. Details on respondents' health status are reported in Table 2. Table 3 summarizes the experiences of the surgeons in open, laparoscopic, TABLE 2. Physician visits data FACTORS PERCENTAGE (%) General well being Well Average Low 83.8 16.2 0.0 Vacation days per year 0 1–10 11–20 21–30 >30 5.4 16.2 24.3 29.7 24.3 Doctor visits per year for general health 0 1–2 3–4 >5 48.7 44.1 5.4 1.8 Number of doctor visits per year for musculoskeletal problems 0 1–2 3–4 >5 57.7 33.3 5.4 3.6 Number of times per year blood test is performed 0 1–2 3–4 >5 31.5 63.1 4.5 0.9 Pain medication taken on a regular basis Yes No 20.7 79.3 Exercise per week 0 1–3 >3 25.2 49.6 25.2 Previous non-work related musculoskeletal injury in the past Yes (Region) Back Neck Arms Legs No 52.3 23.3 15.0 20.0 41.7 47.7 Time spent per day on mobile/computer 1 hour 1–3 hours 3–5 hours >5 hours 8.1 51.4 26.1 14.4 TABLE 3. Background data FACTORS PERCENTAGE (%) Years of experience in open surgery 0 <3 3–5 5–10 >10 0.9 2.7 4.5 26.1 65.8 Years of experience in laparoscopic surgery 0 <3 3–5 5–10 >10 0.0 0.9 6.3 24.3 68.5 Years of experience in robotic surgery 0 <3 3–5 5–10 >10 76.6 15.3 3.6 3.6 0.9 TABLE 4. Bariatric procedures data FACTORS PERCENTAGE (%) Type of bariatric surgeries performed Endo-luminal Sleeve gastrectomy Gastric bypass Gastric bands Not eligible 19.4 98.2 88.0 41.7 0.9 Average number performed per month Endo-luminal Sleeve gastrectomy Gastric bypass Gastric bands Not eligible 6 23 8 3 41 Position bariatric procudure is usually performed in French position Supine position 65.7 34.3 TABLE 1. Demographics VARIABLE Age 45.2 (±7.8) Sex % Male Female 94.7 5.3 Height 175.3 (±7.4) Weight 175.3 (±12.9) Body mass index 27.0 (±3.5) Years Practicing Medicine 19.4 (±7.5) Glove size 7.4 (±0.5) % practice in bariatrics <10% 10–30% 30–60% >60% not eligible 7.1 16.8 20.4 54.0 1.8 Place of practice % Academic center Private hospital Governmental hospital 29.2 63.7 51.3 TABLE 5. Revisional Bariatric Procedures data TYPE OF BARIATRIC SURGERIES PERFORMED Band to sleeve 62.86% Band to gastric bypass 64.76% Sleeve to resleeve 50.48% Sleeve to bypass 66.67% Sleeve to MGB 58.10% Sleeve to duodenal switch 17.14% Bypass to redo bypass 43.81% None 16.19% AVERAGE NUMBER PERFORMED PER YEAR Band to sleeve 15 Band to gastric bypass 14 Sleeve to resleeve 5 Sleeve to bypass 10 Sleeve to MGB 12 Sleeve to duodenal switch 3 Bypass to redo bypass 5 TABLE 6. Difference in location of pain according to bariatric surgery approach in terms of sex WHILE PERFORMING OPEN SURGERY Neck Shoulders Back Wrists Fingers Total Q2: M 27.44% 45 15.85% 26 36.59% 60 8.54% 14 11.59% 19 162.38% 164 Q2: F 30.77% 4 23.08% 3 46.15% 6 0.00% 0 0.00% 0 12.87% 13 WHILE PERFORMING LAPAROSCOPIC SURGERY Neck Shoulders Back Wrists Fingers Total Q2: M 15.77% 35 23.87% 53 24.77% 55 17.57% 39 18.02% 40 219.80% 222 Q2: F 23.53% 4 35.29% 6 23.53% 4 11.76% 2 5.88% 1 16.83% 17 WHILE PERFORMING ROBOTIC SURGERY Neck Shoulders Back Wrists Fingers Total Q2: M 45.00% 9 5.00% 1 10.00% 2 20.00% 4 20.00% 4 19.80% 20 Q2: F 0.00% 0 0.00% 0 0.00% 0 0.00% 0 0.00% 0 0.00% 0 TABLE 7. Difference in location of pain according to bariatric surgery approach in terms of exercise WHILE PERFORMING OPEN SURGERY Neck Shoulders Back Wrists Fingers Total Q15: 0 28.57% 10 14.29% 5 48.57% 17 2.86% 1 5.71% 2 34.65% 35 Q15: 1–3 29.90% 29 13.40% 13 37.11% 36 7.22% 7 12.37% 12 96.04% 97 Q15: >3 22.22% 10 24.44% 11 28.89% 13 13.33% 6 11.11% 5 44.55% 45 WHILE PERFORMING LAPAROSCOPIC SURGERY Neck Shoulders Back Wrists Fingers Total Q15: 0 16.36% 9 25.45% 14 23.64% 13 14.55% 8 20.00% 11 54.46% 55 Q15: 1–3 19.05% 24 26.19% 33 25.40% 32 15.08% 19 14.29% 18 124.75% 126 Q15: >3 10.34% 6 20.69% 12 24.14% 14 24.14% 14 20.69% 12 57.43% 58 WHILE PERFORMING ROBOTIC SURGERY Neck Shoulders Back Wrists Fingers Total Q15: 0 50.00% 1 0.00% 0 0.00% 0 50.00% 1 0.00% 0 1.98% 2 Q15: 1–3 45.45% 5 0.00% 0 18.18% 2 9.09% 1 27.27% 3 10.89% 11 Q15: >3 42.86% 3 14.29% 1 0.00% 0 28.57% 2 14.29% 1 6.93% 7

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