AB080. SOH22ABS149. The consequences of medical tourism in metabolic surgery: a single-centre experience

Background: Difficulty in accessing metabolic surgery in Ireland may result in patients travelling abroad for surgery. While reduced cost and timelier access makes this attractive to patients, concerns have been raised about standards of care and postoperative follow-up in for-profit clinics abroad that offer metabolic surgery. The purpose of this study was evaluating the impact of medical tourism in metabolic surgery on an Irish emergency surgery service.

Methods: A retrospective chart review of patients that had travelled abroad over a 1-year period to undergo self-financed metabolic surgery and subsequently presented to the emergency department (ED) with a postoperative complication was performed.

Results: Twenty-four patients (95.8% female, median age 41 years) presented to the ED with a complication related to metabolic surgery performed abroad. The procedures performed were sleeve gastrectomies (75%, n=18) and laparoscopic gastric bypasses (16.7%, n=6). The most common presenting symptoms were abdominal pain (58.3%, n=14), dysphagia (25%, n=6) and wound issues (12.5%, n=3). Diagnosed complications included intra-abdominal sepsis (45.8%, n=11), gastric outlet obstruction (12.5%, n=3) and port site abscesses (12.5%, n=3). The median inpatient length of stay was 6 days. Five patients (20.8%) required surgical intervention, 3 (12.5%) required interventional radiology and 6 required endoscopic intervention (25%).

Conclusions: The high proportion of patients presenting with postoperative complications following metabolic surgery performed abroad raises serious concerns about the standards of care and absence of patient follow-up in for-profit clinics offering major surgical interventions. Timelier access to weight-loss services in the public sector is critical to overcome this serious issue.

Keywords: Bariatric surgery; medical tourism; metabolic surgery; obesity; weight loss surgery