Perioperative Management of Patient Undergoing Bariatric Surgery

Abstract

Excess of body fat that frequently results in impairment of health push patients to bariatric surgery centers. Obesity is the second leading cause of preventable death in the United States. Obesity is most common in minorities, low-income groups, rural populations, and women, but is increasing in all socioeconomic groups. Obesity is a multifactorial disease, it develops from integration of genetic, environmental, social, behavioral, physiological, metabolic, neuroendocrinal and psychological factors, and the exact etiology is unknown. The complications of obesity may be endocrinal, respiratory, cardiovascular, abdominal, cancer psychological, articular, gynaecological complications. Bariatric operations produce weight loss through two mechanisms; restriction of intake & malabsorption. Postoperative follow-up for the various operations has some common overall themes to determine wound healing, tolerance of oral intake, adjustment to the operation and return to activity to confirm the postoperative nutrition and exercise plan. A multidisciplinary team approach including the nutritionist is essential. Psychologic support and patient-oriented support groups can add significant value to preparation for surgery and afterward. An estimation of the patient's motivation to change eating habits is important. Medical treatment for severe obesity is aimed at reducing body weight through combination of decreased caloric intake and accompanying increases in energy expenditure from moderate exercise. Pulmonary system, intravenous fluid therapy, anesthetic considerations, nutritional therapy are considered perioperative evaluation. Summary 76