The Anatomy of a Weight Recidivism and Revision Bariatric Surgical Clinic
Abstract. Weight recidivism in bariatric surgery failure is multifactorial. It ranges from inappropriate patient selection for primary surgery to technical/anatomic issues related to the original surgery. Most bariatric surgeons and centers focus on primary bariatric surgery while weight recidivism...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2014/721095 |
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| author | C. J. de Gara S. Karmali |
| author_facet | C. J. de Gara S. Karmali |
| author_sort | C. J. de Gara |
| collection | DOAJ |
| description | Abstract. Weight recidivism in bariatric surgery failure is multifactorial. It ranges from inappropriate patient selection for primary surgery to technical/anatomic issues related to the original surgery. Most bariatric surgeons and centers focus on primary bariatric surgery while weight recidivism and its complications are very much secondary concerns. Methods. We report on our initial experience having established a dedicated weight recidivism and revisional bariatric surgery clinic. A single surgeon, dedicated nursing, dieticians, and psychologist developed care maps, goals of care, nonsurgical candidate rules, and discharge planning strategies. Results. A single year audit (2012) of clinical activity revealed 137 patients, with a mean age 49 ± 10.1 years (6 years older on average than in our primary clinic), 75% of whom were women with BMI 47 ± 11.5. Over three quarters had undergone a vertical band gastroplasty while 15% had had a laparoscopic adjustable gastric band. Only 27% of those attending clinic required further surgery. As for primary surgery, the role of the obesity expert clinical psychologist was a key component to achieving successful revision outcomes. Conclusion. With an exponential rise in obesity and a concomitant major increase in bariatric surgery, an inevitable increase in revisional surgery is becoming a reality. Anticipating this increase in activity, Alberta Health Services, Alberta, Canada, has established a unique and dedicated clinic whose early results are promising. |
| format | Article |
| id | doaj-art-3a5eec8e25194360b6426443afa0be90 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-3a5eec8e25194360b6426443afa0be902025-02-03T06:11:22ZengWileyGastroenterology Research and Practice1687-61211687-630X2014-01-01201410.1155/2014/721095721095The Anatomy of a Weight Recidivism and Revision Bariatric Surgical ClinicC. J. de Gara0S. Karmali1University of Alberta, 2-590 Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, CanadaSurgical Director Weight Wise Bariatric Clinic, Minimally Invasive Gastrointestinal and Bariatric Surgery, Alberta Health Services, Edmonton, AB, T5H 3V9, CanadaAbstract. Weight recidivism in bariatric surgery failure is multifactorial. It ranges from inappropriate patient selection for primary surgery to technical/anatomic issues related to the original surgery. Most bariatric surgeons and centers focus on primary bariatric surgery while weight recidivism and its complications are very much secondary concerns. Methods. We report on our initial experience having established a dedicated weight recidivism and revisional bariatric surgery clinic. A single surgeon, dedicated nursing, dieticians, and psychologist developed care maps, goals of care, nonsurgical candidate rules, and discharge planning strategies. Results. A single year audit (2012) of clinical activity revealed 137 patients, with a mean age 49 ± 10.1 years (6 years older on average than in our primary clinic), 75% of whom were women with BMI 47 ± 11.5. Over three quarters had undergone a vertical band gastroplasty while 15% had had a laparoscopic adjustable gastric band. Only 27% of those attending clinic required further surgery. As for primary surgery, the role of the obesity expert clinical psychologist was a key component to achieving successful revision outcomes. Conclusion. With an exponential rise in obesity and a concomitant major increase in bariatric surgery, an inevitable increase in revisional surgery is becoming a reality. Anticipating this increase in activity, Alberta Health Services, Alberta, Canada, has established a unique and dedicated clinic whose early results are promising.http://dx.doi.org/10.1155/2014/721095 |
| spellingShingle | C. J. de Gara S. Karmali The Anatomy of a Weight Recidivism and Revision Bariatric Surgical Clinic Gastroenterology Research and Practice |
| title | The Anatomy of a Weight Recidivism and Revision Bariatric Surgical Clinic |
| title_full | The Anatomy of a Weight Recidivism and Revision Bariatric Surgical Clinic |
| title_fullStr | The Anatomy of a Weight Recidivism and Revision Bariatric Surgical Clinic |
| title_full_unstemmed | The Anatomy of a Weight Recidivism and Revision Bariatric Surgical Clinic |
| title_short | The Anatomy of a Weight Recidivism and Revision Bariatric Surgical Clinic |
| title_sort | anatomy of a weight recidivism and revision bariatric surgical clinic |
| url | http://dx.doi.org/10.1155/2014/721095 |
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