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7 Patient Selection: Pathways to Surgery

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Minimally Invasive Bariatric Surgery

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Abstract

Bariatric surgery is an effective treatment for morbid obesity and has favorable and lasting effects on obesity-associated comorbidities including diabetes, hypertension, dyslipidemia, and obstructive sleep apnea. Perioperative management of this patient population requires a multidisciplinary and comprehensive approach with enhanced recovery schemes to improve both short- and long-term outcomes. The specific medical, psychological, and nutritional needs of each patient pose challenging issues that require appropriate consultation and optimization to reduce morbidity. In addition, refined anesthesiology and technical advancements have allowed bariatric procedures to be liberally applied to the treatment of extreme BMIs, adolescents, and well-selected older patients. Aggressive management of the super obese has brought forth staged procedures and revisional surgeries that are often associated with increased complications. In these cases, in-depth anatomical understanding and preoperative planning are required to mitigate risk. Clinical pathways to facilitate the standardization of perioperative care are essential components for bariatric centers of excellence; however, at present, there is no uniformly accepted practice. In this chapter, we review perioperative care interventions and demonstrate how they fit within a clinical pathway designed to enhance patient selection and postoperative recovery.

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Author information

Authors and Affiliations

  1. Cleveland Clinic Foundation, Bariatric and Metabolic Institute, 9500 Euclid Avenue M61, Cleveland, OH, 44195, USA

    Monica Dua M.D. & Eric P. Ahnfeldt D.O.

  2. Department of Bariatric Medicine, Cleveland Clinic Foundation, Bariatric Metabolic Institute, 9500 Euclid Avenue M61, Cleveland, OH, 44195, USA

    Derrick Cetin D.O.

Authors
  1. Monica Dua M.D.
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  2. Eric P. Ahnfeldt D.O.
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  3. Derrick Cetin D.O.
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Corresponding author

Correspondence to Derrick Cetin D.O. .

Editor information

Editors and Affiliations

  1. Cleveland Clinic Lerner College of Medicine, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio, USA

    Stacy A. Brethauer

  2. Cleveland Clinic Lerner College of Medicine, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio, USA

    Philip R. Schauer

  3. Department of Surgery, Health Sciences Center, University of Virginia Health System, Charlottesville, Virginia, USA

    Bruce D. Schirmer

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Dua, M., Ahnfeldt, E.P., Cetin, D. (2015). 7 Patient Selection: Pathways to Surgery. In: Brethauer, S., Schauer, P., Schirmer, B. (eds) Minimally Invasive Bariatric Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1637-5_7

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  • DOI: https://doi.org/10.1007/978-1-4939-1637-5_7

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1636-8

  • Online ISBN: 978-1-4939-1637-5

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