Background

Background: The COVID-19 pandemic led to widespread adoption of televideo strategies to surgical practices, including bariatric surgery. We describe an effective method of safely incorporating televideo into a busy bariatric surgery practice with increased access to care. Setting: Urban Academic Public Hospital. Objective: To describe the effects of strategic incorporation of televideo into a bariatric surgery practice.

Methods

We conducted a retrospective review of patients undergoing bariatric surgery at two 1-year time intervals—pre-televideo (4/1/2019-3/31/2020) and post-televideo (7/1/2021-6/30/2022). Surgical volume, length of stay, 30-day readmission, 30-day reoperation, mortality, and clinic access were assessed. Multiple operational changes were made to facilitate successful incorporation of the televideo platform and to improve weekly throughput including conversion of preoperative seminars to online videos, streamlining preoperative testing to improve access to surgery, and default conversion of all postoperative in-person visits to televideo visits (close collaboration with a home nursing program and earlier discharge home). Chi-squared and Student’s T tests were used for analysis.

Results

3,718 patients were included (see table 1). 80% of post-operative visits were converted to televideo. Clinic appointment wait time decreased by 92 days and 46 days for initial and post-operative visits, respectively. Overall surgical volume increased by 192%. Length of stay decreased by 0.72 days. There was no significant difference in 30-day readmission rate or 30-day reoperation rate (table 1). There were no mortalities.

Conclusions

The strategic incorporation of televideo into this surgical practice resulted in a significant growth in volume and increased access to care in a largely underserved population.