Page 120 - When surgery alone won’t cut it - Valerie Maureen Monpellier

Chapter 7
to 1.5 years after bariatric surgery. Starting at 2 years after bariatric surgery, patients have a yearly follow-up with the whole team, up to 5 years after surgery.
Patient selection
Study start was in October 2016. Patients were informed and recruited at regular 2- and 3-years follow-up visits after bariatric surgery (because of presumed weight stability and Dutch criteria). Patients who could not read Dutch were not invited for participation. If a patient agreed to participate an electronic invitation with informed consent form was send using Qualtrics software (Qualtrics, Provo, UT). Patients who signed this consent form were subsequently included in this study. The study was ap- proved by the Ethical Research Committee of the Radboud University Medical Center, Nijmegen the Netherlands (2016-2781).
Participation in this study had no effect on further treatment and/or referral to a plastic surgeon.
Body weight
Demographics and weight measurements before and after bariatric surgery were col- lected from the prospective database of the NOK. Body Mass Index (BMI) and percent total weight loss (%TWL) were calculated 23. In addition, it was assessed whether a patient would qualify for referral and reimbursement for BCS according to the current Dutch weight criteria: stable weight > 12 months and a BMI < 35 kg/m2.
Questionnaires
Body contouring surgery
Patients were asked if they wanted to have BCS and if not, asked for the reasons why not (yet).
Screening tool score
Each patient was asked to fill out a modified version of the BAPRAS questionnaire (Appendix 1). The BAPRAS questionnaire was modified with regard to several as- pects:
1. percentage excess weight loss (%EWL) was replaced by %TWL 28,29;
2. stable weight was defined by current weight +/- 5% instead of 5 kilo-
grams;
3. one question was used for evaluating recent life-events;
4. body dysmorphic disorder was not evaluated with schematic drawings 30.
A score was calculated for each patient (Appendix 1). The lowest possible score was minus 21 and the highest possible score was plus 15. Like in the BAPRAS guideline, a score ≥ 8 was defined as being qualified for possible reimbursement and referral to a plastic surgeon 21.
120