S222 E-Posters / Surgery for Obesity and Related Diseases 15 (2019) S137–S254
January 2015 to January 2019 as a continuation of a previous study
in the same department. Patients were matched demographically
and parameters were; operative time, operative complications,-
post-operative pain, length of hospital stay and patient satisfaction
rate.
Results: The average operative time for SILS OL was 93 minutes
versus 69 minutes for multiple port surgery. One patient required
placement of one additional port and one had conversions to con-
ventional laparoscopic surgery. No open surgery was needed. Pain
score of 3/10 in SILS OL compared to 5/10 in the multi-trocar
group. Weight loss was approximately 91% of EW in 12 months’
post operatively. No patients required re- operation or readmission
during the 30 days after surgery.
Conclusions: Single port omega loop surgery can be done safely in
selected patients especially those with BMI less than 40, in the
hands of experienced laparoscopic surgeons and the availability
of rotating instrumentation.
A538
IMPROVING OUTCOMES IN OUTPATIENT
BARIATRIC SURGERY
Titus Duncan1; Maykong Leepalao2; 1The Surgery Center
of Atlanta, Atlanta GA; 2Peachtree Surgical & Bariatrics,
Atlanta GA
Background: Currently, bariatric surgery is most commonly per-
formed in a hospital setting with a length of stay ranging from 1
- 3 days. In this presentation, we discuss our selection process
and perioperative techniques used to make ambulatory outpatient
surgery outcomes safe and feasible. The objectives of this presen-
tation are to demonstrate the benefits of performing ambulatory
outpatient bariatric surgery on select patients. Mayny bariatric pa-
tients require in-hospital stay as a result of comorbid conditions.
However, these patients should be differentiated from patients of
lower risk who may benefit from an outpatient approach. Addition-
ally, we defined periooperative strategies that may consistently
improve the outpatient bariatric experience.
Methods: We prospectively randomized patients to undergo sta-
pling bariatric procedures with on an inpatient or ambulatory
outpatient basis using selection criteria. Outcomes were measured
based on, but not limited to, readmissions, ER visits, complications
requiring interventional surgery, morbidity and mortality.
Results: Data presented in this series suggests that select patients
undergoing bariatric surgery combined with defined perioperative
strategies may be safely performed on an outpatient ambulatory
basis.
Conclusions: In the field of bariatric surgery, as in the field of most
disease states, there is no "one size fits all” approach. Appropriate
treatment should be individualized in accordance to patients’ needs.
We present a protocol of patient selection and perioperative
techniques that may improve outcomes in patients who undergo bar-
iatric surgery on an outpatient basis. Such a process may very well
reduce healthcare costs and possibly have an impact on today’s opioid
crisis.
A539
IS THERE ANY BENEFITS OF RECORDING
EVERY BARIATRIC PROCEDURE?
Adrain Marius Nedelcu1; Sergio Carandina1;
Patrick Noel2; 1Centre Chirurgical de l’Obesite, Toulon; 2Centre
Chirurgical de l’Obesite, Aubagne
Background: The critical role of the learning curve for different
bariatric procedures to diminish the postoperative complication
rates is very well known. Recording every procedure could reduce
every learning curve for different bariatric procedures. The aim of
our study was to evaluate the correlation between recording every
bariatric surgery and postoperative analysis of early or late postop-
erative complications.
Methods: 377 patients underwent a bariatric procedure between
January2018-January2019. There were:314 sleeve;54 bypass and
9 bands. All procedures were recorded and all patients were
enrolled in IFSO registry.
Results: There were 10 patients with surgical postoperative com-
plications: 3 leaks,6 hemorrhages and one stenosis.All complica-
tions were recorded following sleeve except one bleeding from
jejuno-jejunal anastomosis. In 3 cases a site of active bleeding
was identified. After reviewing the video, in 2 cases the site
was correlated with the initial procedure. 2 out 3 cases of leak
following sleeve was treated purely endoscopic and no potential
mechanism was identified. Two other potential benefits were
identified: a better evaluation of gastric pouch for the treatment
of ulcer post bypass and the review of two preoperative incidents
with the whole team. Two negative diagnostic laparoscopies were
performed. All other cases were completed by laparoscopy with
no conversion.
Conclusions: To record every bariatric procedure could help in un-
derstanding the mechanism of certain complications, especially
when the analysis is performed within the team. Still recording
the procedure did not prevent the negative diagnostic laparoscopy,
but could play in the future a role from medico-legal aspect.
A540
SOCIOCULTURAL FACTORS INFLUENCING
EATING PRACTICES AMONG OFFICE
WORKERS IN URBAN SOUTH KOREA
EUNJU Sung1; Sohyun Park2; Dongjoon Lee1;
1
KANGBUK SAMSUNG HOSPITAL, SEOUL; 2Hallym University
Background: To understand the sociocultural factors affecting the
eating behaviors of South Korean employees. Design: In-depth in-
dividual interviews. Setting: Two metropolitan areas of South Ko-
rea. Participants: Thirteen male and 9 female office workers.
Phenomenon of Interest: The effects of sociocultural factors on of-
fice workers’ eating behaviors. Analysis: The researchers tran-
scribed and analyzed audio-recorded interviews using thematic
analysis.
Results: Among social and economic factors, participants with a
family described a connection between female employment and
 E-Posters / Surgery for Obesity and Related Diseases 15 (2019) S137–S254
lower frequency of home-cooked family meals. Working parents
felt guilty about their need to depend on eating outside the home
and eating processed foods because of their schedules. In addition,
competitive and stressful working environments negatively
affected workers’ nutritional choices. Regarding cultural factors,
given the powerful influences of collectivism and Confucianism
on daily life, hierarchy and group harmony clearly had an impor-
tant role in workers’ everyday food choices. These included
choosing menus that were most suitable for group meals and hav-
ing to miss dinner time while waiting until higher-position workers
to leave work in the evening.
Conclusions: In this sociocultural setting, targeting office workers
and changing social norms for healthy eating may be more effec-
tive than providing individualized interventions. These findings
may be transferable to other, similar Asian countries.
A541
BODY COMPOSITION ANALYSIS OF YOUTH
PRE AND POST BARIATRIC SURGERY
Melissa Santos1; Hailey (Beiner) Handzel2;
Jessica Zimmerman3; Christine Finck3; 1Connecticut
Children’s Medical Center, Newington CT; 2CT Children’s, Hartford
CT; 3CCMC, Hartford CT
Background: Different metrics have been suggested as measures
of weight loss and improved health. However, few studies have
examined various aspects of body composition pre and post adoles-
cent bariatric surgery. This abstract will summarize findings from a
sample of youth who underwent bariatric surgery and highlight
suggestions for future research and care.
Methods: A small subset of adolescents (N 5 9) who underwent
the laparoscopic sleeve gastrectomy procedure, participated in a
prospective database for the use of their data and had body compo-
sition analyses from approximately six months prior to surgery, one
month prior to surgery and six months after surgery were included
in this study. Body composition was measured with a Tanita scale.
Results: Pre surgically 6 of the 9 adolescents lost fat percentage
while all lost fat percentage after surgery. Post surgically, muscle
mass decreased in all but one adolescent and Body Mass Index
(BMI) decreased in all. 6 of the 9 adolescents were 18 at the
time of surgery allowing for examination of more body composi-
tion factors. Total body water decreased for all following surgery
and bone mass decreased in 5 of the 6 adolescents. Basal metabolic
rate decreased in all adolescents after surgery while metabolic age
increased in 3.
S223
Conclusions: These results in a small sample show a variety of
body changes following bariatric surgery. By examining measures
of weight and body composition, it may be possible to craft strate-
gies to improve their health including optimization of postopera-
tive nutrition and more comprehensive measures of progress
outside of weight loss.
A542
PRE AND POST-OPERATIVE COMPARISONS
BETWEEN ADOLESCENTS AND YOUNG
ADULTS UNDERGOING BARIATRIC SURGERY
Melissa Santos1; Richard Seip2; Darren Tishler3;
Pavlos Papasavas3; Christine Finck4; 1Connecticut Children’s
Medical Center, Newington CT; 2HH; 3Hartford Healthcare,
Hartford CT; 4CCMC, Hartford CT
Background: With the increasing rates of obesity and its comorbid-
ities occurring in younger ages, the use of bariatric surgery has
increased in adolescents. However, limited research has examined
the impact of age on bariatric surgery pre-operative presentation
or post-operative course. Data on 4,235 patients who underwent
index bariatric procedures in 2017 was extracted from the
MBSAQIP PUF. Pre and post-operative variables in 289 adolescents
(age: 13-17.99; mean 16.73; SD 5 1.04) were compared to 3,946
young adults (age: 18 - 22.99; mean 20.90; SD 5 1.42).
No statistically significant differences were seen in pre-operative
Body Mass Index (BMI) closest to surgery (46.69 in adolescents
vs 47.26 in young adults) or highest recorded BMI (48.38 in ado-
lescents vs 48.95 in young adults) between groups. More Hispanics
underwent surgery as adolescents than young adults (29.4% vs
20.2%; p 5 .01). 14.5% of adolescents were on treatment for dia-
betes versus 9.7% of young adults (p,.05). Over 20% of adoles-
cents had obstructive sleep apnea versus 14.7% of young adults
(p,.05). Young adults had a greater number of visits for treatment
of dehydration and visits to the emergency department.
Bariatric surgery is often seen as the treatment of last resort for ad-
olescents. These findings suggest that adolescents undergoing bar-
iatric surgery do not have increased risk of post-operative
complications and may have a less complicated post-operative
course. However, their pre-operative presentation may be more
impaired with a greater impact of diabetes treatment and obstruc-
tive sleep apnea suggesting a need for earlier, and more intense,
intervention.