Preoperative Evaluation of the Patient Undergoing Bariatric Surgery

Bariatric surgical procedures are performed in a high-risk population with many comorbid conditions and can be challenging and complex. Both the American College of Surgeons and the American Society for Metabolic and Bariatric Surgery (ASMBS) require established preoperative pathways as an essential component of designation as a certified bariatric center. Guidelines addressing preoperative patient evaluation were published in the SAGES guideline of March 2008 on the clinical application of laparoscopic bariatric surgery.¹ A substantial focus of these guidelines was on psychological and nutritional aspects of the patient in the preoperative setting, leaving the medical and surgical evaluation to the judgment of the operating surgeon. When reviewing the practice of preoperative evaluation, it is important to recognize that preoperative assessment protocols may be institution specific and may vary from region to region.