General Conditions for Bariatric Surgery

Contraindications

It is important to know all conditions that may exclude a person from a bariatric program, given that most are relatives.

Who are not candidates for bariatric surgery?

The fact that one person with an obesity prognosis meets the NHI (National Health Consensus) regarding over weight, to undergo bariatric surgery, doesn’t necessarily make you a candidate to such procedures due to the existent relative contradictions that may temporarily or definitely postpone a surgery of such nature.

With the increase of experience in bariatric surgery with minimum invasion and low complications rate currently reported, many of the medical conditions that were previously considered contradictions, are no longer so. Patients are not just evaluated by the surgeon, but also by multidisciplinary groups. The group determines the consensus and according to the general conditions, the current state of the pre-existent illnesses, as well as additional factors that may increase the risk for the patient, the surgical procedure may or may not proceed. They also give recommendations to improve health state and reduce risks.

 What can be certain contraindications?

The selection of patients to undergo bariatric surgery has been changing in the last decade, due to the advance in the minimally invasive procedures, technologies and increase of experience. Also, there has been more information on results in specific groups, based on age, weight, related illnesses or comorbidities and severity of these. There are no absolute contradictions in bariatric surgery; however, the benefits expected must surpass the inherent risks of the procedure the patient will undergo. Some relative contraindications may include: severe heart failure, unstable ischemic heart disease, terminally ill pulmonary disease, active oncological disease or under treatment, liver cirrhosis with portal hypertension, active dependency on alcohol or drugs and severely affected intellectual capacity. Other relative contraindications may be related to specific procedures, like for example Crohn’s disease in gastric bypass or bilio-pancreatic bypass. Before, very obese or super obese patients (BMI bigger to 60 Kg/m2), patients with an extensive abdominal surgery background and multiple adherences as well as life extremes were a motif to contraindicate a bariatric surgery. Nowadays there are bariatric programs for adolescents and patients older than 65 years of age. Also, patients with extreme obesity are operated and with severe diseases after they’ve done the pre-op preparation and control of risk factors to lower surgical anesthetic risks.

Most contraindications for bariatric surgery are relative, however, they require of special attention by the multidisciplinary team to improve the patient’s health; also the patient must follow all indications and/or recommendations given by the treating doctor to get the most of the bariatric surgery. In case that the contraindication is or becomes absolute, there are other options less invasive that may be done in a bariatric program.


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OCC’s epidemiologist is closely monitoring the COVID-19 status and is actively issuing updates as they are available. The Centers for Disease Control and the World Health Organization are the most trusted sources online.  While the CDC has announced new mask protocols for vaccinated individuals, there will be no changes for our office protocols for patients, guests, and staff members as the announcement does not apply to hospitals or medical facilities. Masks are still a requirement for all patients, guests and staff at our facility.

As we reinitiate weight loss surgery, we are constantly adapting and installing new and updated safety measures.

Weight loss surgery is medically necessary.

Bariatric Surgery and the clash of two pandemics.   

Major metabolic and bariatric surgery Societies and colleges globally are now calling for the safe resumption of bariatric and metabolic surgery before the COVID-19 pandemic is declared over. 

The sooner bariatric surgery can be safely performed, the quicker obesity, type 2 diabetes, and other diseases can be reduced or resolved as they are not only chronic they are also progressive.  Obesity is also linked to more than 40 diseases including type 2 diabetes, hypertension, heart disease, stroke, sleep apnea, osteoarthritis, and at least 13 different types of cancer.

A recent statement from the ASMBS says “Before COVID-19 began, it was clear that patients with obesity were ‘safer through surgery.’ In the era of COVID-19, ‘safer through surgery’ for patients with obesity may prove to be even more important than before.” Obesity and Metabolic syndrome have been identified as an independent risk factor for adverse outcomes including death among COVID-19 patients.

See here for full COVID-19 update. 

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