Panel report: best practices for the surgical treatment of obesity

Abstract

Background Bariatric surgery is a rapidly growing field. Advances in surgical technologies and techniques have raised concerns about patient safety. Bariatric surgeons and programs are under increased scrutiny from regulatory agencies, insurers, and public health officials to provide high quality and safe care for bariatric patients at all phases of care. Methods During the 2009 annual meeting of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), a panel of experts convened to provide updated information on patient safety and best practices in bariatric surgery. The following article is a summary of this panel presentation. Results and ConclusionsWeight loss surgery is a field that is evolving and adapting to multiple external pressures. Safety concerns along with increasing public scrutiny have led to a systematic approach to defining best practices, creating standards of care, and identifying mechanisms to ensure that patients consistently receive the best and most effective care possible. In many ways, bariatric surgery and multidisciplinary bariatric surgery programs may serve as a model for other programs and surgical specialties in the near future.

Clinical Practice Guidelines For The Perioperative Nutritional, Metabolic, And Nonsurgical Support Of The Bariatric Surgery Patient2013 Update: Cosponsored By American Association Of Clinical Endocrinologists, The Obesity Society, And American Society For Metabolic & Bariatric Surgery

“…Informed consent for bariatric surgery is a dynamic process of education and comprehension in addition to the disclosure of risks and benefits (134 [EL 3, NE]; 135 [EL 2, PCS]). Educational objectives, active teaching and learning processes, and assessments are recommended (134 [EL 3, NE]; 136 [EL 4, NE]; 137 [EL 4, NE]) and should be communicated at a 6th–8th grade reading level (138 [EL 4, NE]). Multimedia tools for informed consent and patient education show promise for improving comprehension (139 [EL 2, NRCT]).…”

Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: Cosponsored by american association of clinical endocrinologists, The obesity society, and american society for metabolic & bariatric surgery*

“…Informed consent for bariatric surgery is a dynamic process of education and comprehension in addition to the disclosure of risks and benefits (134 [EL 3, NE]; 135 [EL 2, PCS]). Educational objectives, active teaching and learning processes, and assessments are recommended (134 [EL 3, NE]; 136 [EL 4, NE]; 137 [EL 4, NE]) and should be communicated at a 6th‐8th grade reading level (138 [EL 4, NE]). Multimedia tools for informed consent and patient education show promise for improving comprehension (139 [EL 2, NRCT]).…”

The impact of previous fundoplication on laparoscopic gastric bypass outcomes: a case-control evaluation

“…A comprehensive education and evaluation process for bariatric surgery by an experienced team in a multidisciplinary program is the preferred pathway. Unfortunately, even if the patient, his or her primary care provider, and the bariatric surgery team reach a consensus that bariatric surgery is the best treatment option for GERD and obesity-associated conditions, insurance companies often decline to provide benefits for LRYGB as a GERD treatment [33]. Many morbidly obese patients who would otherwise be best served with LRYGB for GERD are forced to undergo laparoscopic Nissen due to financial limitations and policy exclusions.…”