title: A focus on surgical preoperative evaluation of the bariatric patient--the Cleveland Clinic protocol and review of the literature.
abstract: Bariatric surgery is well established as a safe and effective treatment for morbid obesity and related metabolic diseases. As an elective procedure, it is critical that individuals considering bariatric surgery should be carefully selected, extensively evaluated, and optimized in order to achieve optimal outcomes. This patient population has unique and challenging issues, including an extensive range of potential medical, psychiatric, and psychological comorbidities, and often patients have unrealistic expectations of the surgery. Therefore, a multidisciplinary, comprehensive and timely assessment preoperatively is of great importance. Individual bariatric units utilise different preoperative patient evaluation protocols. There is at present no uniformly accepted or recommended practice. In this article we describe what we believe are the essential components of a preoperative bariatric surgery evaluation, with supporting evidence for each recommendation. We also present a protocol currently in practice at a high volume bariatric center of excellence; the Bariatric and Metabolic Institute in the Cleveland Clinic, Ohio.
authors.affiliation: Bariatric and Metabolic Institute, M61 Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA. merons@ccf.org
authors.forename: S
authors.initials: S
authors.lastname: Eldar
authors.forename: H M
authors.initials: HM
authors.lastname: Heneghan
authors.forename: S
authors.initials: S
authors.lastname: Brethauer
authors.forename: P R
authors.initials: PR
authors.lastname: Schauer
mesh_terms: D050110:Bariatric Surgery; D002985:Clinical Protocols; D006801:Humans; D009767:Obesity, Morbid / Q000601:surgery*; D011300:Preoperative Care