title: Impact of preoperative teaching on surgical option of patients qualifying for bariatric surgery.
abstract: BACKGROUND
  During the last 5 years, the performance of bariatric operations has doubled via our outpatient obesity clinic. Currently, 52% of the patients presenting for weight loss are interested in bariatric surgery. Gastric banding and Roux-en-Y gastric bypass are the two laparoscopic procedures proposed. The aim of this study was to evaluate the impact of preoperative teaching on the patients' surgical option.
  
  
  METHODS
  All the candidates for bariatric surgery were submitted to preoperative teaching and those between February 2001 and December 2002 are the subject of this study. The teaching consisted of 3 weekly interactive 2-hour sessions. During the first session, the patients were asked about the type of operation that they had in mind: gastric banding, gastric bypass, or not yet decided. The same questions were repeated at the end of the third session, with an additional possible answer: no surgery.
  
  
  RESULTS
  297 consecutive patients with a BMI >35 kg/m(2) with at least one severe co-morbidity, were submitted to preoperative teaching. 80% of the patients were women. Median age was 41 years. Before teaching, 68 patients (23%) were uncertain, 100 (34%) favored gastric banding, and 129 (43%) wanted a gastric bypass. After education, only 3 patients (1%) remained uncertain, 45 (15%) changed their surgical option, and 27 (9%) declined surgery. The proportion of patients opting for gastric banding decreased from 34% to 20%, whereas those electing bypass increased from 43% to 70%.
  
  
  CONCLUSIONS
  Preoperative training provides an informed and better patient selection for bariatric surgery. It helps the patients understand the various surgical options, and makes their decision easier.
authors.affiliation: Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland. vittorio.giusti@chuv.hospvd.ch
authors.forename: V
authors.initials: V
authors.lastname: Giusti
authors.forename: A
authors.initials: A
authors.lastname: De Lucia
authors.forename: V
authors.initials: V
authors.lastname: Di Vetta
authors.forename: J M
authors.initials: JM
authors.lastname: Calmes
authors.forename: E
authors.initials: E
authors.lastname: Héraïef
authors.forename: R C
authors.initials: RC
authors.lastname: Gaillard
authors.forename: P
authors.initials: P
authors.lastname: Burckhardt
authors.forename: M
authors.initials: M
authors.lastname: Suter
mesh_terms: D000328:Adult; D000368:Aged; D003657:Decision Making; D005260:Female; D015390:Gastric Bypass; D015391:Gastroplasty; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010353:Patient Education as Topic