Obesity and Metabolic Surgery Society of India (OSSI) Recommendations for Bariatric and Metabolic Surgery Practice Durin
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Obesity and Metabolic Surgery Society of India (OSSI) Recommendations for Bariatric and Metabolic Surgery Practice During the COVID-19 Pandemic Sandeep Aggarwal 1 & Kamal Mahawar 2 & Manish Khaitan 3 & Praveen Raj 4 & Randeep Wadhawan 5 & NandaKishore Dukkipati 6 & Kuldeepak S Kular 7 & Arun Prasad 8 & Aparna Govil Bhasker 9 & Vandana Soni 10 & Brijesh Madhok 11 & Sarfaraz Baig 12 & Raj Palaniappan 13 & H. V. Shivaram 14 & Deep Goel 15 & Vivek Bindal 16 & Sukhvinder Saggu 17 & Rajesh Shrivastava 18 & Sumeet Shah 19 & Shrihari Dhorepatil 20 & Rajesh Khullar 21 Received: 26 May 2020 / Revised: 14 August 2020 / Accepted: 17 August 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Bariatric and metabolic surgery (BMS), the only effective option for patients with obesity with or without comorbidities, has been stopped temporarily due to the ongoing novel corona virus disease (COVID-19) pandemic. However, there has been a recent change in the governmental strategy of dealing with this virus from ‘Stay at Home’ to ‘Stay Alert’ in many countries including India. A host of health services including elective surgeries are being resumed. In view of the possibility of resumption of BMS in near future, Obesity and Metabolic Surgery Society of India (OSSI) constituted a committee of experienced surgeons to give recommendations about the requirements as well as precautions to be taken to restart BMS with emphasis on safe delivery and high-quality care. Keywords Bariatric surgery . COVID-19 . Coronavirus . Resumption . Pandemic
Background The COVID-19 pandemic has resulted in postponement of all planned elective operations. Unfortunately, bariatric and metabolic surgery (BMS) has taken the worst brunt of the pandemic. Most centers have put a complete halt to new referrals and operations. Obesity is associated with several comorbidities including type 2 diabetes mellitus (T2DM), hypertension, and obstructive sleep apnea (OSA) [1]. Patients with obesity have an impaired immune response resulting in enhanced risk of various infections including COVID-19 [2]. Worryingly, the severity of COVID-19 is worse in patients suffering from obesity [3, 4]. As the BMS has been deferred due to the COVID-19 pandemic, the patients with obesity continue to suffer from its adverse consequences [5–7].
* Sandeep Aggarwal [email protected] Extended author information available on the last page of the article
In view of the above and considering obesity and bariatric surgery to be of equal importance as other chronic lifethreatening diseases and cancer, the Obesity and Metabolic Surgery Society of India (OSSI) decided to frame recommendations which will help bariatric surgeons to prepare for the possible recommencement of bariatric surgery in the near future. These recommendations are predominantly based on the opinion of experts given the paucity of data on this subject. The published recommendations by several national and international societies were also taken in account while compiling these [8–11
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