Surgical Management of Obesity and Postoperative Care

Abstract

KEY POINTS An estimated 8-10 million people suffer from extreme obesity, defined as a body mass index (BMI) of greater than 40 kg/m(2). Bariatric Surgery has advanced significantly over the years and can reverse or greatly ameliorate numerous life-threatening comorbidities associated with obesity. There are two main types of bariatric surgery: restrictive surgeries, such as gastric banding, and malabsorptive surgeries, which include Roux-en-Y gastric bypass (RYGB), biliopancreatic diversion (BPD), and sleeve gastrectomy. Because of the increasing number of surgeries performed worldwide each year, a working knowledge of the preoperative evaluation, surgeries performed, and the resulting changes in nutritional requirements, gut function, and physiology is recommended for all healthcare professionals. Through selection of appropriate surgical candidates and limiting surgery to regional centers with high-volume bariatric surgery, perioperative mortality can be minimized. Structured postoperative follow-up can improve effectiveness and long-term safety for patients.