ASMBS position statement on preoperative patient optimization before metabolic and bariatric surgery

Carter, Jonathan; Chang, Julietta; Birriel, T. Javier; Moustarah, Fady; Sogg, Stephanie; Goodpaster, Kasey; Benson-Davies, Sue; Chapmon, Katie; Eisenberg, Dan

doi:10.1016/j.soard.2021.08.024

Cited by 53 publications

(27 citation statements)

References 271 publications

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“…The 1991 NIH Consensus Statement recommends that patients who are candidates for MBS should be evaluated by a "multidisciplinary team with access to medical, surgical, psychiatric, and nutritional expertise" [1]. The value of assessments by such a team has since been reiterated [103][104][105], reflecting the recognition of the complexity of the disease of obesity, and the ability to provide a comprehensive risk/benefit analysis when considering MBS. This may also facilitate the patient's ability to comprehend the life-long changes that can be expected after surgery, benefitting from the expertise of different healthcare providers [106].…”

Section: Patient Evaluationmentioning

confidence: 99%

“…The nutritional status of patients seeking MBS is important [ 104 , 110 ]. A nutritional assessment by a registered dietitian with expertise in MBS can help obtain a comprehensive weight history, identify maladaptive eating behaviors or patterns, and correct any micronutrient deficiencies prior to surgery.…”

Section: Patient Evaluationmentioning

confidence: 99%

“…A nutritional assessment by a registered dietitian with expertise in MBS can help obtain a comprehensive weight history, identify maladaptive eating behaviors or patterns, and correct any micronutrient deficiencies prior to surgery. A registered dietitian can also provide preoperative nutrition education and prepare the patient for expected dietary changes after MBS [ 103 , 104 ]. In addition, a registered dietitian with expertise in MBS can assist in the management of postoperative patients who may be experiencing food intolerances, malabsorption issues and micronutrient deficiencies, and weight regain.…”

Section: Patient Evaluationmentioning

confidence: 99%

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2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Indications for Metabolic and Bariatric Surgery

Eisenberg

Shikora

Aarts³

et al. 2022

OBES SURG

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278

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Major updates to 1991 National Institutes of Health guidelines for bariatric surgeryMetabolic and bariatric surgery (MBS) is recommended for individuals with a body mass index (BMI) >35 kg/m2, regardless of presence, absence, or severity of co-morbidities.MBS should be considered for individuals with metabolic disease and BMI of 30-34.9 kg/m2.BMI thresholds should be adjusted in the Asian population such that a BMI >25 kg/m2 suggests clinical obesity, and individuals with BMI >27.5 kg/m2 should be offered MBS.Long-term results of MBS consistently demonstrate safety and efficacy.Appropriately selected children and adolescents should be considered for MBS.(Surg Obes Relat Dis 2022; https://doi.org/10.1016/j.soard.2022.08.013) © 2022 American Society for Metabolic and Bariatric Surgery. All rights reserved.

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Section: Patient Evaluationmentioning

confidence: 99%

Section: Patient Evaluationmentioning

confidence: 99%

Section: Patient Evaluationmentioning

confidence: 99%

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2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Indications for Metabolic and Bariatric Surgery

Eisenberg

Shikora

Aarts³

et al. 2022

OBES SURG

Self Cite

278

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“…The multidisciplinary preoperative process often involves multiple visits with different health providers in preparation for bariatric surgery [ 1 ] [ 7 ]. Response to the COVID-19 pandemic limited patient access to healthcare providers/facilities and necessitated rapid action and adjustment to ensure the uninterrupted provision of healthcare to patients.…”

Section: Discussionmentioning

confidence: 99%

Complete Telehealth for Multidisciplinary Preoperative Workup Does Not Delay Time to Metabolic and Bariatric Surgery: a Pilot Study

et al. 2022

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Purpose The COVID-19 pandemic accelerated implementation of telehealth throughout the US healthcare system. At our institution, we converted a fully integrated multidisciplinary bariatric clinic from face-to-face visits to entirely telehealth video/telephone visits. We hypothesized telehealth would increase the number of provider/patient encounters and therefore delay time to surgery. Methods This is a retrospective review of consecutive patients who underwent total telehealth preoperative workup. Demographics, comorbidities, and surgical characteristics were compared to the same number of consecutive patients who underwent a face-to-face approach 12 months prior, using a Wilcoxon test for continuous variables and chi-square or Fisher’s exact test for categorical variables. Differences between time and surgery were compared using inverse probability of treatment-weighted estimates and number of preoperative visits using Poisson regression with distance to hospital as a confounder. Noninferiority margin for time to surgery was set to 60 days, and the number of visits was set to 2 visits. Results Between March of 2020 and December of 2021, 36 patients had total telehealth workup, and were compared to 36 patients in the traditional group. Age, sex, body mass index, and comorbidities did not differ between groups. The average number of days to surgery was 121.1 days shorter in the telehealth group (90% bootstrap CI [− 160.4, − 81.8]). Estimated shift in the total number of visits was additional .76 visits in the traditional group (90% CI [.64, .91). Conclusions The total telehealth approach to preoperative bariatric multidisciplinary workup did not delay surgery and decreased number of total outpatient visits and time to surgery. Graphical abstract

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“…Herein, we show that the lockdown determined by the SARS-CoV-2 pandemic has negatively affected the preoperative program of patients with obesity who were scheduled for BS, resulting in a postponement of surgery until the resumption of surgical activity. The aim of the pre-BS program is not only in weight loss to simplify the surgical procedure but also to correct MD, and to improve IR and obesity-linked low-grade systemic inflammation [ 6 , 18 , 19 ]. Numerous studies have been shown to decrease BW, left hepatic lobe volume, and correct MD in patients with obesity scheduled for BS [ 10 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of SARS-CoV-2 Lockdown on the Preoperative Care Program of Patients Scheduled for Bariatric Surgery

et al. 2022

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Objectives: To evaluate the effect of the SARS-CoV-2 lockdown on dietary habits, body weight, left hepatic lobe volume, use of micronutrient supplements, micronutrient status, frequency of physical activity, and evolution of comorbidities in patients undergoing preoperative care for BS. Materials and Methods: We prospectively evaluated the dietary habits (including use of micronutrient supplements and frequency of physical activity) of 36 patients who were candidates for BS from March to May 2020; 7-day food dietary records, body weight, left hepatic lobe volume by ultrasound, micronutrient status, and evolution of comorbidities were assessed. Results: All patients completed the study. Of the participants, 44.4% (16/36), 47.2% (17/36), and 27.8% (10/36) followed the preoperative indications for vegetables, fruits, and legumes, respectively, whereas over 50% did not. Furthermore, 30.6% (11/36) and 55.6% (20/36) of participants followed the prescribed recommendations for carbohydrates/sweets products and alcohol, respectively. A total of 61.1% (22/36) of participants experienced new foods and new culinary preparations. In addition, at the time of the study, we found that only 11.1% (4/36) were engaged in prescribed physical activity and only 36.1% (13/36) were taking prescribed micronutrient supplements. Compared to the initial weight, we observed an increased body weight and body mass index (+4.9%, p = 0.115; +1.89%, p = 0.0692, respectively), and no improvement in left hepatic lobe volume, micronutrient status, or comorbidities was recorded for any patient in the anamnesis. Conclusions: Lockdown determined by the SARS-CoV-2 pandemic has negatively affected the preoperative program of BS candidates, resulting in a postponement to the resumption of bariatric surgical activity.

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ASMBS position statement on preoperative patient optimization before metabolic and bariatric surgery

Cited by 53 publications

References 271 publications

2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Indications for Metabolic and Bariatric Surgery

2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Indications for Metabolic and Bariatric Surgery

Complete Telehealth for Multidisciplinary Preoperative Workup Does Not Delay Time to Metabolic and Bariatric Surgery: a Pilot Study

Impact of SARS-CoV-2 Lockdown on the Preoperative Care Program of Patients Scheduled for Bariatric Surgery

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