Common perioperative and early postoperative complications and management

Bariatric operations, like any surgical procedure, necessarily impose some risk upon obese patients who are frequently afflicted by co-morbidities such as diabetes, hypertension, peripheral vascular disease, obstructive sleep apnea, asthma, hypercholesterolemia and degenerative joint disease. Additionally, severely obese individuals oftentimes suffer from reduced mobility and a predisposition to venous stasis, increasing the risk of thromboembolic events [1]. Despite the fact that bariatric patients may be at higher baseline surgical risk compared to patients of normal body mass index, the complication rates associated with bariatric surgery remain low due to the wide adoption of laparoscopy and careful monitoring of outcomes. Additionally, candidates for bariatric surgery are carefully evaluated preoperatively. To comply with insurance requirements, patients are frequently monitored for up to 6 months prior to surgery. Most will complete psychiatric, medical, and nutritional evaluations, and undergo medical optimization in order to minimize surgical risk. Patients are also counseled on smoking cessation and monitored for compliance to preoperative diet regimens, as these may have significant impact on surgical outcomes.