Current attitudes to the laparoscopic bariatric operations among European surgeons

The current attitudes among European bariatric surgeons toward the laparoscopic bariatric operations were examined.

150 questionnaires were sent to recognized bariatric surgeons in Europe, and 60% responded.

47% of respondents perform laparoscopic Roux-en-Y gastric bypass (LRYGBP), 81% laparoscopic adjustable gastric banding (LAGB), and 29% laparoscopic biliopancreatic diversion with or without duodenal switch (L-BPD/BPDDS). For BMI <40, 57% of respondents would only perform LAGB, 7% LRYGBP, 2% vertical banded gastroplasty (VBG), 3% L-BPD/BPDDS, and 2% intra-gastric balloon. For BMI 40-50, 43% of respondents prefer LAGB, 11% LRYGBP, 8% VBG, 5% L-BPD/BPDDS, and 33% contemplate several operations. For BMI 50-60, 30% prefer LAGB, 23% LRYGBP, 5% VBG, 16% L-BPD/BPDDS, and 26% tailor each patient's treatment. For BMI >60, 20% prefer LAGB, 24% LRYGBP, 37% L-BPD/BPDDS, 2% VBG, and 17% consider more than one operation. Although important, BMI and patient eating habits are not significant in choosing an operation for 25% of respondents. Interestingly, 39% of the surgeons offer laparoscopic bariatric surgery to so-called pediatric patients (<18). Of these, 76% favor LAGB, 8% LRYGBP, 8% L-BPD and 4% other procedures.

The overall body of respondents prefers laparoscopic procedures. The responses suggest that at lower BMI there is a higher trend for restrictive operations. However, as BMI increases, combined and malabsorptive operations are preferred. At least one-third of surgeons offer bariatric surgery to patients with age <18 years, and here LAGB is greatly preferred.