Bariatric Surgical Practice and Patient Care

OBJECTIVE: To examine if preoperative weight loss correlates to postoperative weight loss 2 and 3 years after surgery. METHODS: A review was conducted of bariatric surgery patients who underwent either gastric bypass or sleeve gastrectomy during 2015-2018 and had 3-year follow-up data. Demographic and outcome data were collected. A best-fit regression model for weight loss was constructed. RESULTS: Eight hundred fifty-nine patients underwent surgery during the selected period, of which 199 patients (23%) were analyzed...

BACKGROUND: Suboptimal weight loss (SWL) occurs up to 30% after sleeve gastrectomy (SG). Conversion to Roux-en-Y gastric bypass (cRYGB) has shown heterogeneous results in terms of additional weight loss and resolution of weight-related comorbidities. We aim to evaluate mid-term outcomes of cRYGB specifically for SWL after SG. METHODS: All patients who underwent cRYGB for SWL from April 2010 to June 2019 from prospective registries at three affiliated tertiary care centers were retrospectively reviewed...

BACKGROUND: Bariatric complications may occur during pregnancy, potentially causing serious maternal and fetal problems. The aim of this study was to determine the current practice and preferences of bariatric surgeons regarding the pregnancy care of fertile women before and after bariatric surgery. METHODS: A 26-question anonymous online survey was designed and sent to all bariatric surgeons of the Dutch Society of Metabolic and Bariatric Surgery. RESULTS: At least one bariatric surgeon from each bariatric center ( n  = 18) completed the survey...

BACKGROUND: Bariatric surgery is the most effective treatment for weight loss and obesity-related comorbidity resolution. However, bariatric surgery is not readily offered in specific populations due to the lack of data assessing its feasibility. This study intends to evaluate bariatric surgery in patients with an existing ostomy. METHODS: We conducted a retrospective case series to assess the safety of Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) in patients with an end ileostomy or colostomy...

BACKGROUND: In response to the COVID-19 pandemic, elective surgical procedures have been delayed. Even with the implementation of surgical societies' recommendations, patient safety remains a concern. This study evaluates the postoperative outcomes in patients undergoing bariatric surgery after reopening (RO) elective surgery during the COVID-19 pandemic. METHODS: All patients who underwent bariatric surgery from September 2015 to July 2020 were included. Patients were divided into two cohorts: the pre-COVID-19 (PC) cohort and the RO cohort...

Background: Although numerous studies outside the United States (U.S.) have explored weight loss and comorbidity resolution among patients with class I obesity (body mass index [BMI] 30-34.9 kg/m2 ) after metabolic surgery, few U.S.-based studies have been conducted. Objective: Our aim was to compare weight loss and comorbidity resolution among U.S. patients with class I obesity, who underwent laparoscopic sleeve gastrectomy (LSG) versus Roux-en-Y gastric bypass (RYGB). Methods: Weight loss and comorbidity data among only patients with class I obesity, who underwent LSG or RYGB, were examined...

Objective: To prospectively evaluate the postoperative morbidity, mortality, and weight loss evolution of patients who underwent a bariatric procedure during 1 year of follow-up. Methods: Since July 2016, a total of 101 patients' data have been prospectively registered in a database. Comorbidities, operating time, hospital stay, early and late complications rate, and weight loss evolution after 1 year of follow-up were recorded. Results: The mean age was 38.41 ± 11.05 years with a mean body mass index (BMI) of 49...

Background: Despite rising rates of obesity among human immunodeficiency virus (HIV)-positive individuals, the safety and tolerability of surgery in this population have not been established. The primary aim of this study was to examine the safety of bariatric surgery and rate of in-hospital postoperative complications in morbidly obese patients with HIV. Materials and Methods: The U.S. Nationwide Inpatient Sample database was queried between 2004 and 2014 for discharges with codiagnoses of morbid obesity and bariatric surgery...

Background/Objectives: A history of physical and sexual abuse has been implicated in weight gain. Although bariatric surgery is effective for weight loss in severely obese individuals, we investigated whether bariatric surgery patients who self-report a history of physical and/or sexual abuse have differential outcomes regarding weight loss, body mass index (BMI), quality of life (SF-36), and depressive symptoms (Center for Epidemiologic Studies Depression [CESD]) compared with nonabused patients. Materials and Methods: Standardized assessments at baseline and follow-up visits were performed on 103 obese (BMI >35) female bariatric surgery patients (mean age: 44...

Purpose: Robotic-assisted Roux-en-Y gastric bypass (RARYGB) is a procedure that is used with increasing frequency in the United States. Among other bariatric procedures, RARYGB is a good model for the robotic platform because it allows hand-sewn suturing and energy devices application. The aim of this study was to conduct a literature review of robotic approach in RARYGB, its learning curve using the cumulative sum (CUSUM) method, and our experience as Center of Excellence recognized by the American Society for Metabolic and Bariatric Surgery (ASMBS)...

Weight loss medications are effective to confer additional weight loss after bariatric surgery in the general population, but they have not been evaluated in adults 60 years of age and older. We performed a retrospective study identifying 35 patients who were ≥60 years old and had undergone Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) from 2000 to 2014, and were subsequently prescribed weight loss medications. Linear regression analyses were performed to determine beta coefficients of certain predictor variables being associated with weight loss...

Background: Opiate-based pain medications may incur adverse effects following bariatric surgery. The aim of this study was to evaluate the efficacy of intravenous Acetaminophen (IVAPAP) on length of stay (LOS) after laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery. Methods: This was a prospective, double-blind, randomized controlled trial conducted from October 2011 to March 2014 at a 416-bed teaching hospital. Eighty-nine total patients were included (control group, n  = 45; treatment group, n  = 44)...

Introduction: Obesity and metabolic syndrome are increasingly prevalent in the United States, particularly among African Americans and Latinos. Bariatric surgery has become one of the primary treatment modalities for obesity and type 2 diabetes. However, fewer Latinos and African Americans are undergoing bariatric surgery than whites. The aim of this article is to describe the disparities in seeking and accessing bariatric surgery, describe the outcomes following bariatric procedures in Latinos and African Americans, and offer recommendations and future research directions that may assist in addressing these disparities...

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Purpose: To determine whether preoperative weight loss goals are associated with postoperative weight loss and whether the effect is modified by preoperative depressive symptoms. Methods: Sixty-three women from an ongoing cohort study who were undergoing first-time bariatric surgery at a large, academic hospital in Pittsburgh, PA, were included in this subanalysis. They were assessed preoperatively and 12 months postoperatively in regard to anthropometric and biobehavioral factors. Multivariable linear regression models were used to estimate associations between weight loss goals, expressed as percentage excess body mass index loss (%EBMIL), and postoperative %EBMIL, as well as test effect modification by depressive symptoms...

Objective: To investigate whether bariatric patients experience changes in the enjoyment of health-promoting behaviors, and how those changes relate to weight loss success. Materials and Methods: Online lifestyle survey for bariatric patients ≥18 years old who had undergone gastric bypass or sleeve gastrectomy ≥1 year earlier. Changes in the enjoyment of eating behaviors and exercise were surveyed, and associations with weight loss success were analyzed. The role of obtaining external support since surgery was investigated...

Obesity is rampant across the spectrum of age, gender, and race in the Unites States. Paralleling this epidemic, kidney stone prevalence is also rising, affecting nearly 1 in 11 individuals. Bariatric surgical procedures, such as Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), are the most effective weight loss options for morbidly obese or severely obese individuals with comorbidities. A number of studies have linked kidney stone development to bariatric surgical history, particularly RYGB, which portends up to a threefold increase in calcium oxalate stone risk compared with age-matched, obese controls...

Background: Implementation of a multidisciplinary conference (MC) attended by medical, surgical, nutrition, bioethics, and psychology specialists may help identify treatment plans for bariatric surgery candidates with a high-risk psychiatric profile. Methods: Data were assessed for all bariatric candidates evaluated by the MC in an academic center between January 2009 and December 2010. Results: A total of 134 patients of 2798 patients assessed by four different psychologists were subsequently evaluated by the MC...

Background: Some institutions and insurance companies mandate a preoperative weight loss regimen prior to bariatric surgery. Previous studies suggest little to no correlation between preoperative and postoperative weight loss for laparoscopic Roux-en-Y gastric bypass (RNYGB). This study examined the impact of preoperative weight change for patients undergoing laparoscopic sleeve gastrectomy (LSG). Materials and Methods: A retrospective analysis was performed on patients undergoing LSG at the authors' institution from 2010 to 2012...

Purpose: The aims of this study were to describe the most common medications reported by candidates for weight loss surgery and to consider the potential implications for patient care. Methods: A secondary data analysis of data from bariatric surgery patients enrolled in a randomized, controlled trial. At study entry, participants recorded their use of prescription medications they had taken in the previous 90 days. The Anatomical Therapeutic Chemical (ATC)/Defined Daily Dose (DDD) Index 2014 was used to classify medications...