Preoperative Care of the Bariatric Patient
Preoperative care of the bariatric patient starts before the patient arrives. Both evaluation and individualized risk assessment are essential for achieving best outcomes and allowing the patient to give a truly informed consent. Best preoperative care will yield a comprehensive understanding of a patient’s medical history as it pertains to predicted outcomes, cardiac health, venous thromboembolism risk, sleep architecture and pulmonary function, gastroesophageal anatomy and Helicobacter pylori status, and psychological ability to comply with required postoperative recommendations for health maintenance and to achieve success following weight loss surgery. This chapter will describe evidence-based comprehensive preoperative evaluation of the bariatric patient, discuss risk assessment to optimize patient selection and informed consent, and explain establishment of preoperative pathways.
KeywordsObstructive Sleep Apnea Bariatric Surgery Continuous Positive Airway Pressure Bariatric Patient Weight Loss Surgery
- 1.Gastrointestinal Surgery for Severe Obesity. NIH Consens Statement 1991. http://consensus.nih.gov/1991/1991GISurgeryObesity084html.htm. Accessed 11 Jul 2012.
- 8.DeMaria EJ, Murr M, Byrne TK, Blackstone R, Grant JP, Budak A, et al. Validation of the obesity surgery mortality risk score in a multicenter study proves it stratifies mortality risk in patients undergoing gastric bypass for morbid obesity. Ann Surg. 2007;246(4): 578–82.PubMedCrossRefGoogle Scholar
- 13.Finks JF, English WJ, Carlin AM, Krause KR, Share DA, Banerjee M, Michigan Bariatric Surgery Collaborative; Center for Healthcare Outcomes and Policy, et al. Predicting risk for venous thromboembolism with bariatric surgery: results from the Michigan Bariatric Surgery Collaborative. Ann Surg. 2012;255(6):1100–4.PubMedCrossRefGoogle Scholar
- 17.Gasa M, Salord N, Fortuna AM, Mayos M, Embid C, Vilarrasa N, et al. Optimizing screening of severe obstructive sleep apnea in patients undergoing bariatric surgery. Surg Obes Relat Dis. 2013;9:539–46.Google Scholar