Roux-en-Y gastric bypass. Image courtesy of Ethicon Endo-Surgery, Inc.

By Sylvia Foley, AJN senior editor

People who are obese (BMI of 30 kg/m2 or greater) are prone to a laundry list of ills. They’re not only at greater risk for diseases such as type 2 diabetes, coronary heart disease, stroke, and osteoarthritis—they’re also more apt to experience discrimination and psychological abuse, and to suffer from anxiety and depression. Many have repeatedly tried to lose weight through diet, exercise, psychotherapy, and pharmacotherapy, to no avail. Until recently, there was little else providers could offer them.

But bariatric surgery, known to be an effective treatment for obesity and obesity-related comorbidities, is becoming an increasingly common option. In 1998, only about 13,000 bariatric procedures were performed in the United States; by 2007 that figure had jumped to 200,000, and it continues to rise. With prevalence rates for overweight and obesity also at record highs in this country, more nurses will likely find themselves caring for patients who have undergone such procedures.

In this month’s CE, “Outcomes and Complications after Bariatric Surgery,” authors Lauren Gagnon and Emily Karwacki Sheff explain the two main types of bariatric surgery and outline five of the most common procedures in the United States: 

  • Roux-en-Y gastric bypass (RYGB)
  • adjustable gastric banding (AGB)
  • vertical sleeve gastrectomy (VSG)
  • biliopancreatic diversion with du­odenal switch
  • vertical banded gastroplasty

Gagnon and Sheff then discuss the outcomes and complications of bariatric surgery, noting that although it is “generally safe,” there is always some risk. Depending on the surgery, complications might include “dumping” syndrome, cholelithiasis, pulmonary embolism and deep vein thrombosis, and anastomotic leak, among others. The authors close with detailed nursing implications for pre- and postoperative patient care. For example, with regard to preoperative evaluation and patient teaching, they explain the importance of the following:

  • helping patients know what to expect upon awakening from surgery
  • discussing postoperative pain control before surgery
  • ensuring that patients have realistic weight-loss goals
  • preparing patients for certain aesthetic changes

Bariatric surgery has proven to be most effective when patients adhere to postoperative recommendations and attend follow-up visits and support groups. The full article is free online. And if you’ve worked with patients who have undergone bariatric surgery, we’d love to hear about your experiences.

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