The Impact of COVID-19 on Bariatric Surgery: During and Post-Pandemic

Introduction: There was a significant decline in bariatric surgery during Covid 19 pandemic. The aim of this study was to examine the impact of COVID-19 on various bariatric surgery procedures and surgical approaches, laparoscopic (L) vs. robotic (R). Methods: MBSAQIP data from 2015 to 2023 were analyzed. The data was stratified by time period (pre-COVID: 2015-2019; COVID: 2020; Early Recovery: 2021; Full Recovery: 2022-2023). Kruskal-Wallis and Chi-squared tests compared continuous and categorical variables, respectively. Poisson regression analyzed case volume trends, while linear and logistic regression examined trends in continuous and binary patient characteristics. Results: A total of 1,784,178 patients were included. Bariatric surgery cases declined significantly in 2020 (pandemic year) but recovered steadily, with a slight decline in 2023. The use of robotic platforms grew steadily over nine years, with linear growth from 2015 to 2019, followed by a significant acceleration post-COVID. Laparoscopic surgeries declined during COVID, with partial recovery later, while robotic surgeries, especially in the robotic Roux-en-Y (R-RYGB) group, recovered more quickly. The robotic single anastomosis duodeno-ileal bypass with sleeve gastrectomy (R-SADI-S) procedure saw the largest drop during COVID with minimal recovery. Black and Hispanic patients had increased access to care post-pandemic, particularly in the robotic surgery group. Conclusion: The study examines the effects of the COVID-19 pandemic on bariatric surgery in the U.S., showing a rise in robotic surgery use and improved access for minority groups, trends that have continued after the pandemic. These changes may result from national efforts to enhance healthcare access for minority patients. Future research should investigate the factors contributing to these shifts.