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The SAGES Manual of Bariatric Surgery pp 161–172Cite as

Preoperative Checklist for Bariatric Surgery

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Abstract

Bariatric and metabolic surgery is more effective than medical therapy for patients with morbid obesity as well as patients with type II diabetes mellitus and class I and II obesity (BMI more than 30 kg/m2) (Khan et al., Eur J Nutr 55:25–43, 2016; Adams et al., N Engl J Med 357:753–61, 2007; Khan et al., Health Commun 1–8, 2017; Fischer et al., Obes Surg 27:1684–90, 2017; Sjöström et al., Engl J Med 357:741–52, 2007; Keating et al., Diabetes Care 32:580–4, 2009; Schauer et al., N Engl J Med 376:641–51, 2017; Ikramuddin et al., JAMA 309:2240–9, 2013). However, the process of undergoing bariatric and metabolic surgery requires the setup of a multidisciplinary team (MDT) (Mingrone et al., Lancet 386:964–73, 2015). This MDT will allow for appropriate preoperative evaluation, adequate perioperative facility setup, as well as postoperative lifelong follow-up. In addition, the MDT is needed to ensure ample patient education, engagement and setting realistic expectation for the process of workup, potential perioperative complications, and the need for lifelong follow-up. In this chapter, we will review the minimum required multidisciplinary team setup, a proposed pathway for preoperative evaluation, recommended infrastructure in the perioperative period, as well as a proposed structure for lifelong follow-up after bariatric surgery. In addition, we will review the members of the MDT, preoperative checklist for patients undergoing bariatric and metabolic surgery in primary, revisional bariatric surgery (for weight regain or complications after bariatric surgery), adolescent patients, and high-risk patients. The preoperative checklist will include different pathways including outpatient, anesthesia, inpatient, and emergency department pathways. Furthermore, we present a proposed algorithm to screen patients for obstructive sleep apnea and manage patients with anemia and components of the smoking cessation program.

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Abbreviations

BMI:

Body mass index

MDT:

Multidisciplinary team

OSA:

Obstructive sleep apnea

STOP BANG:

Snoring, tiredness, observed apnea, previous history of HTN, BMI > 35, age > 55, neck circumference > 35 cm females and 40 cm in males, and gender male

Type II DM:

Type II diabetes mellitus

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Author information

Authors and Affiliations

  1. Bariatric & Metabolic Institute (BMI) Abu Dhabi, Chief, Division of General, Thoracic and Vascular Surgery, Adjunct Associate Professor of Surgery, Abu Dhabi, United Arab Emirates

    Abdelrahman A. Nimeri (Director)

Authors
  1. Abdelrahman A. Nimeri
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Correspondence to Abdelrahman A. Nimeri .

Editor information

Editors and Affiliations

  1. Foregut and Bariatric Surgeon, Division of Gastrointestinal and Minimally Invasive Surgery, The Oregon Clinic, Portland, Oregon, USA

    Kevin M. Reavis

  2. Long Island Jewish Forest Hills Hospital, Department of Surgery, Hofstra-Northwell School of Medicine, Forest Hills, New York, USA

    Allison M. Barrett

  3. Institute Chief, Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates

    Matthew D. Kroh

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Nimeri, A.A. (2018). Preoperative Checklist for Bariatric Surgery. In: Reavis, K., Barrett, A., Kroh, M. (eds) The SAGES Manual of Bariatric Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-71282-6_15

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  • DOI: https://doi.org/10.1007/978-3-319-71282-6_15

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