Preoperative Evaluation and Preparation for Patients

Abstract

Bariatric surgery has significantly decreased overall mortality and has imparted a survival advantage to patients undergoing this surgery [21], and the number of such surgeries has now rapidly increased worldwide, even in Asia [18]. Because bariatric patients usually have uncontrolled comorbidities related to obesity and psychological problems, a multidisciplinary team approach for the systematic evaluation and management of these patients is seen as an important component of a bariatric and metabolic surgery practice. In the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) guidelines, the team leader is a surgeon who must have acquired the proper education and surgical training, and other important team members include nutritionists, psychologists with specific training and experience, psychiatrists, and medical subspecialists (endocrinologists, anesthesiologists, and cardiologists, among others) [24]. The team not only preoperatively evaluates and optimizes the patients for surgery but also provides them with preoperative teaching and perioperative care. As a result, a thorough understanding of proper patient selection, appropriate preoperative evaluation, and preparation for patients and successful outcomes of bariatric and metabolic surgery can be achieved in clinical practice. This chapter reviews issues related to preoperative evaluation and preparation for bariatric surgery.