ABSTRACT
This chapter outlines the common problems encountered in the postoperative management of the bariatric-surgery patient. Morbid obesity is a complex disease with a multitude of associated diseases that require special management after bariatric surgery. The most striking changes in medical symptoms after bariatric surgery are those that are most difficult to quantify. Nutritional deficiencies are common after bariatric surgery for two reasons: inadequate dietary intake and the surgical procedure itself. Roux-en-Y gastric bypass (RYGB) is considered the gold standard for achieving a sustainable weight loss in the morbidly obese. With the introduction of a laparoscopic technique for RYGB, risks associated with this surgery decreased dramatically. In a recent series of surgeries comparing open gastric bypass to laparoscopic technique, laparoscopic RYGB was associated with decreased operative mortality, wound infection, and incisional hernia. The most disastrous complication associated with RYGB, a staple-line leak at the gastrojejunal anastomosis, has a reported incidence of 4.6%.
