The role of staging laparoscopy in complex bariatric surgery

SummaryDetermining which patients will benefit from bariatric surgery is complex; however, in those who have had previous bariatric surgery or extensive abdominal surgery, this can be particularly challenging. Decisions are often made based on assumptions rather than a complete assessment of all the anatomical and physiological factors. Adopting the approach utilised in gastrointestinal surgery with a diagnostic or staging laparoscopy, it may be possible to more accurately stage disease and determine fitness bariatric surgery. Laparoscopy is relatively low risk and contributes critical information with regard to access, post ‐operative anatomical changes and response to anaesthetic. Additionally, it allows surgeons to accurately determine the feasibility of undertaking a procedure and facilitates a more precise discussion with patients regarding suitability for surgery. Denying patients bariatric procedures based on a n incomplete assessment of risk is unfair. Scenarios in which patients have had previous surgery, particularly bariatric surgery are increasingly common with the numbers requiring revisional surgery steadily rising. Although only applicable in highly selected, very complex cases, diagnostic laparosc opy adds critical information in the preoperative assessment of patients, not only improving care but potentially widening the numbers considered eligible for bariatric surgery. Our limited experience with staging laparoscopy in patients with previous complex abdom...
Source: Clinical Obesity - Category: Eating Disorders & Weight Management Authors: Tags: Case Report Source Type: research