Current Surgical Therapies for Morbid Obesity Patient Selection

In keeping with the National Institutes of Health Consensus Development Conference Statement on Gastrointestinal Surgery for Morbid Obesity, patients with a BMI exceeding 40 kg per m2 or 35 kg per m2 with obesity-related comorbidities are candidates for the surgical treatment of morbid obesity.10 Surgery for morbid obesity should be offered to patients who are well-informed and motivated, and who are acceptable to operative risks. Patients should be evaluated preoperatively by a mul-tidisciplinary team of nutritionists, nurse clinicians, internists, psychologists or psychiatrists, and surgeons. Patients should be screened for common obesity-related conditions, and these conditions should be optimized. Tests to be considered are chest x-ray; electrocardiography, cardiac stress testing, and echocardiography for cardiac disorders; arterial blood-gas and pulmonary-function testing, with arterial blood gases for the hypoventilation syndrome and polysomnography for the sleep apnea syndrome; barium swallow; TS, lipid panel, HbA1c, and fasting blood sugar. The choice of procedures with risks and benefits must be clearly explained to the patient, as should be the need for long-term follow-up.

The optimal operation is still a matter of much discussion. In reality, careful patient selection can result in a close match between operation and patient. This also includes the very real and not-too-infrequent denial of any surgical option for the inappropriate surgical candidate. The most commonly performed surgical procedures in the U.S. are the Lap-Band, the Roux en Y gastric bypass, and the bilopancreatic diversion.

Get The Body Of Your Dreams

Get The Body Of Your Dreams

Everybody wants to lose weight. This is one fact that is supported by the countless weight loss programs on the market along with the numerous weight loss products, ranging from snack bars, powdered juices, shakes and even slimming soaps and lotions.

Get My Free Ebook


Post a comment