Introduction

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In the past 2 decades, dramatic changes have occurred in the population of women having infants. A greater percentage of women are entering pregnancy obese, with the related increased morbidities observed. Because many reproductive-age women present for medical care to obstetrician/gynecologists, these practitioners are ideally positioned to have an important effect on this phenomenon. For example, when patients present for their annual examination or preconceptual counseling, guidance regarding weight loss before pregnancy can be offered. During pregnancy, obstetricians can encourage the patient to follow guidelines for weight gain in pregnancy, recently reexamined by the Institute of Medicine, to prevent excessive weight gain, which women often are unable to shed after delivery. After co…

Preparing for and Managing a Pregnancy After Bariatric Surgery

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The number of bariatric surgeries performed in the United States has increased exponentially. Given that most patients are female and of reproductive age, it is important for clinicians who manage women’s health issues to be aware of the surgery, its long-term goals, and the potential effect on future pregnancies. Most pregnancies after bariatric surgery have successful outcomes with decreased occurrences of gestational diabetes and hypertension and lower birth weight compared with control patients. Following nutritional guidelines and supplementation in the event of deficiencies are critical in the provision of prenatal care to this unique population. Other important issues include a multidisciplinary team management, a different approach to screening for gestational diabetes, careful eva…

Exploring The Role Of Endoscopy In Treating Obesity

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The American Society for Gastrointestinal Endoscopy (ASGE) and the American Society for Metabolic & Bariatric Surgery (ASMBS) have issued a new white paper on the potential role of endoscopic bariatric therapies (EBTs) in treating obesity and obesity-related diseases like Type 2 diabetes… (Source: Health News from Medical News Today)

Weight Loss Preceding Laparoscopic Gastric Bypass Improves Acute Outcomes: Comment on "Preoperative Very Low-Calorie Diet and Operative Outcome After Laparoscopic Gastric Bypass" [Invited Critique]

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(Source: Archives of Surgery)

Bandwagon Forward: Comment on "Safety of Laparoscopic vs Open Bariatric Surgery" [Invited Critique]

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(Source: Archives of Surgery)

Effect of the Volume of Fluids Administered on Intraoperative Oliguria in Laparoscopic Bariatric Surgery: A Randomized Controlled Trial [Original Article]

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Conclusions  In patients undergoing laparoscopic bariatric surgery, intraoperative urine output is low regardless of the use of relatively high-volume fluid therapy. The results suggest that we should reconsider the common practice to administer intraoperative fluids in response to low urine output. Further studies are required to evaluate these data in other surgical patient populations.
Trial Registration  clinicaltrials.gov Identifier: NCT00753402 (Source: Archives of Surgery)

Bariatric Surgery in High-Risk Patients: Is it Time to Reconsider? [From JAMA]

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(Source: Archives of Surgery)

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Safety of Laparoscopic vs Open Bariatric Surgery: A Systematic Review and Meta-analysis [Review Article]

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Conclusion  Laparoscopic surgery may be a safer treatment than open surgery for patients requiring bariatric surgery. (Source: Archives of Surgery)

Preoperative Very Low-Calorie Diet and Operative Outcome After Laparoscopic Gastric Bypass: A Randomized Multicenter Study [Original Article]

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Conclusions  Although weight reduction with a 14-day VLCD regimen before laparoscopic gastric bypass performed in high-volume centers seems to reduce the perceived difficulty of the procedure, only minor effects on operating time, intraoperative complications, and short-term weight loss could be expected. However, the finding of reduced postoperative complication rates suggests that such a regimen should be recommended before bariatric surgery. (Source: Archives of Surgery)

Costs and usage of healthcare services before and after open bariatric surgery.

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CONCLUSION: Although bariatric surgery is the only path towards sustained weight loss for morbidly obese patients, the direct costs over the first year after the procedure are greater. Further studies, with longer follow-up, might elucidate whether long-term reversal of this trend would occur.
PMID: 22069127 [PubMed – in process] (Source: Sao Paulo Medical Journal)

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