title: Current attitudes to the laparoscopic bariatric operations among European surgeons.
abstract: BACKGROUND
  The current attitudes among European bariatric surgeons toward the laparoscopic bariatric operations were examined.
  
  
  METHODS
  150 questionnaires were sent to recognized bariatric surgeons in Europe, and 60% responded.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Obesity Surgery Unit, Department of Gastrointestinal Surgery, Institute of Digestive Diseases, Hospital Clinic, University of Barcelona, Corporació Sanitària Clínic, Villaroel 170, 08036 Barcelona, Spain. homerorivas@msn.com
authors.forename: Homero
authors.initials: H
authors.lastname: Rivas
authors.forename: José-Luis
authors.initials: JL
authors.lastname: Martínez
authors.forename: Salva
authors.initials: S
authors.lastname: Delgado
authors.forename: Jusep
authors.initials: J
authors.lastname: Vidal
authors.forename: Antonio M
authors.initials: AM
authors.lastname: Lacy
mesh_terms: D001291:Attitude of Health Personnel; D015904:Biliopancreatic Diversion / Q000706:statistics & numerical data*; D015992:Body Mass Index; D005060:Europe; D015390:Gastric Bypass / Q000706:statistics & numerical data*; D015391:Gastroplasty / Q000706:statistics & numerical data*; D006801:Humans; D010535:Laparoscopy; D010818:Practice Patterns, Physicians'