Background

The Covid-19 pandemic necessitated changes in many facets of bariatric care, including increased use of telemedicine for preoperative consultation and postoperative clinic visits. This study analyzed the effect of preoperative telemedicine visits (PTV) versus in-person visits (IPV) at a single high-volume bariatric center.

Methods

We conducted a retrospective review of bariatric surgery patients from 2018-2020, excluding revisional operations. Demographics, weight metrics, perioperative details and complications, and postoprative outcomes were collected. Patients with PTV were compared to the IPV cohort with univariate statistics and a multivariate regression model for failed excess weight loss (<50%) at six months.

Results

185 patients were included, with 61% having purely IPVs and 39% in the PTV cohort. The two groups had similar preoperative weight loss, demographics, comorbidities, and early perioperative outcomes. PTV patients had higher percent excess weight loss (EWL) than the IPV group at six months (55% vs 43%, P<0.01), but no significant difference at one year (61% vs 52%, P=0.11). There were no differences in comorbidity resolution. On univariate analysis, PTV was associated with lower EWL failure at six months and remained an independent predictor on multivariate analysis (OR 0.47, P=0.03).

Conclusions

A structured program of telemedicine visits for preoperative evaluation and counseling prior to bariatric surgery was implemented safely and effectively at this center with comparable perioperative and weight loss outcomes compared to patients who had standard in-person clinic visits. Continued use and expansion of telemedicine visits may be warranted as a method of increasing patient access and hospital resource utilization.