Raymond J Taddeucci1, Atul K Madan, David S Tichansky. 1. Section of Minimally Invasive Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee 38163, USA.
Abstract
BACKGROUND:Laparoscopic Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding are 2 common weight loss procedures. This investigation examined the effect of a preoperative educational seminar (ES) and surgeon visit (SV) on patients' choice of bariatric procedure. METHODS: In our practice, patients choose their procedure. New patients receive an overview of both procedures in an ES, including the risks and benefits, and then meet individually with a surgeon (SV) to answer any additional questions. Three identical surveys (before the ES, after the ES, and after the SV) were given to new patients who voluntarily participated in this study. The survey queried procedure choice and influencing factors. RESULTS: A total of 47 patients participated. Of these 47 patients, 31 had researched the procedures before the ES and 13 were unsure of the differences between laparoscopic Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding before the ES, 4 were after the ES, and 1 was after the SV. Also, 11% of patients changed their procedure choice as a result of attending the ES and SV; 15%, 13%, and 13% of patients were willing to be randomized to either procedure before the ES, after the ES, and after the SV, respectively. CONCLUSIONS: Only 11% of patients changed their procedure choice as a result of attending the ES and SV. Thus, patient decisions are usually made before meeting the surgeon, and the information provided at the ES and SV simply reinforced those decisions. Only 13% of patients were willing (4% very willing and 9% somewhat willing) to be randomized to either procedure (laparoscopic Roux-en-Y gastric bypass or laparoscopic adjustable gastric banding). It is likely that patients had confidence in, and were comfortable with, 1 procedure over the other, and therefore were unwilling to undergo the other procedure.
RCT Entities:
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding are 2 common weight loss procedures. This investigation examined the effect of a preoperative educational seminar (ES) and surgeon visit (SV) on patients' choice of bariatric procedure. METHODS: In our practice, patients choose their procedure. New patients receive an overview of both procedures in an ES, including the risks and benefits, and then meet individually with a surgeon (SV) to answer any additional questions. Three identical surveys (before the ES, after the ES, and after the SV) were given to new patients who voluntarily participated in this study. The survey queried procedure choice and influencing factors. RESULTS: A total of 47 patients participated. Of these 47 patients, 31 had researched the procedures before the ES and 13 were unsure of the differences between laparoscopic Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding before the ES, 4 were after the ES, and 1 was after the SV. Also, 11% of patients changed their procedure choice as a result of attending the ES and SV; 15%, 13%, and 13% of patients were willing to be randomized to either procedure before the ES, after the ES, and after the SV, respectively. CONCLUSIONS: Only 11% of patients changed their procedure choice as a result of attending the ES and SV. Thus, patient decisions are usually made before meeting the surgeon, and the information provided at the ES and SV simply reinforced those decisions. Only 13% of patients were willing (4% very willing and 9% somewhat willing) to be randomized to either procedure (laparoscopic Roux-en-Y gastric bypass or laparoscopic adjustable gastric banding). It is likely that patients had confidence in, and were comfortable with, 1 procedure over the other, and therefore were unwilling to undergo the other procedure.
Authors: Andrew L Weinstein; Bryan J Marascalchi; Matthew A Spiegel; John K Saunders; Angela Fagerlin; Manish Parikh Journal: Obes Surg Date: 2014-11 Impact factor: 4.129