Chapter 11 Bariatric surgery and post-operative outcome
Mark Bellamy and
Michel Struys
- • Outcomes following anaesthesia and surgery in the morbidly obese are reasonably good.
- • Several large reported series have failed to confirm body mass index as an independent risk factor for adverse outcome.
- • Poor outcome is related to the presence of co-morbidities.
- • Patients undergoing open surgery have been shown to develop higher post-operative into abdominal pressures than those undergoing similar surgical procedures laparoscopically.
- • Three principles underlying bariatric surgery are reduction in stomach size, gastric outlet restriction, and malabsorption.
- • Early surgical procedures such as jejunoileal bypass had an unacceptably high post-operative complication rate.
- • Current surgical procedures include laparoscopic adjustable gastric banding and gastric bypass Roux loop reconstruction.
- • These techniques have a relatively low complication rate.
- • There is a clearly demonstrable effect of programs size, with larger programs having better outcomes.
