title: Implementing laparoscopy in Brazil's National Public Health System: the bariatric surgeons' point of view.
abstract: BACKGROUND
  Although Brazilian National Public Health System (BNPHS) has presented advances regarding the treatment for obesity in the last years, there is a repressed demand for bariatric surgeries in the country. Despite favorable evidences to laparoscopy, the BNPHS only performs this procedure via laparotomy.
  
  
  OBJECTIVE
  1) Estimate whether bariatric surgeons would support the idea of incorporating laparoscopic surgery in the BNPHS; 2) If there would be an increase in the total number of surgeries performed; 3) As well as how BNPHS would redistribute both procedures.
  
  
  METHODS
  A panel of bariatric surgeons was built. Two rounds to answer the structured Delphi questionnaire were performed.
  
  
  RESULTS
  From the 45 bariatric surgeons recruited, 30 (66.7%) participated in the first round. For the second (the last) round, from the 30 surgeons who answered the first round, 22 (48.9%) answered the questionnaire. Considering the possibility that BNPHS incorporated laparoscopic surgery, 95% of surgeons were interested in performing it. Therefore, in case laparoscopic surgery was incorporated by the BNPHS there would be an average increase of 25% in the number of surgeries and they would be distributed as follows: 62.5% via laparoscopy and 37.5% via laparotomy.
  
  
  CONCLUSIONS
  1) There was a preference by laparoscopy; 2) would increase the number of operations compared to the current model in which only the laparotomy is available to users of the public system; and 3) the distribution in relation to the type of procedure would be 62.5% and 37.5% for laparoscopy laparotomy.
authors.affiliation: Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Samanta
authors.initials: S
authors.lastname: Sussenbach
authors.affiliation: Faculdade de Ceilândia, Universidade de Brasília, Brasília, DF.
authors.forename: Everton N
authors.initials: EN
authors.lastname: Silva
authors.affiliation: Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Milene Amarante
authors.initials: MA
authors.lastname: Pufal
authors.affiliation: Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Carina
authors.initials: C
authors.lastname: Rossoni
authors.affiliation: Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Daniela Schaan
authors.initials: DS
authors.lastname: Casagrande
authors.affiliation: Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Alexandre Vontobel
authors.initials: AV
authors.lastname: Padoin
authors.affiliation: Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Cláudio Corá
authors.initials: CC
authors.lastname: Mottin
mesh_terms: D001291:Attitude of Health Personnel; D050110:Bariatric Surgery / Q000379:methods; D001938:Brazil; D003695:Delivery of Health Care; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D011634:Public Health; D066231:Surgeons; D011795:Surveys and Questionnaires