Vertical banded gastroplasty: a treatment for morbid obesity

Bariatric surgery for obesity and metabolic conditions in adults

This review summarizes recent evidence related to the safety, efficacy, and metabolic outcomes of bariatric surgery to guide clinical decision making. Several short term randomized controlled trials have demonstrated the effectiveness of bariatric procedures for inducing weight loss and initial remission of type 2 diabetes. Observational studies have linked bariatric procedures with long term improvements in body weight, type 2 diabetes, survival, cardiovascular events, incident cancer, and quality of life. Perioperative mortality for the average patient is low but varies greatly across subgroups. The incidence of major complications after surgery also varies widely, and emerging data show that some procedures are associated with a greater risk of substance misuse disorders, suicide, and nutritional deficiencies. More research is needed to enable long term outcomes to be compared across various procedures and subpopulations, and to identify those most likely to benefit from surgical intervention. Given uncertainties about the balance between the risks and benefits of bariatric surgery in the long term, the decision to undergo surgery should be based on a high quality shared decision making process.

Bariatric Implications of Critical Care Nursing

The delivery of optimum nursing care to morbidly obese patients in critical care presents unique challenges in critical thinking, planning, and teamwork. The purpose of this article is to review the special needs of this patient population and to provide a template to guide proactive nursing care planning in critical care settings.