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Bariatric Surgery & Care - International Nurses Association

Obesity is chronic in the United States. Morbid obesity is currently at the highest rate ever reported, which puts an emphasis on bariatric surgery and care. 

Types of Bariatric Surgery

Gastric Sleeve- this is a fairly safe surgery, as it does not deplete the body of nutrients as some do.Many patients opt for this as it can usually be done with minimally invasive procedures. Care for the patient following this surgery is minimal; in fact it is often done on an outpatient basis.
 
Gastric Bypass- this surgery is more invasive, and it dumps a portion of minerals out, without allowing for absorption by the body. Patients that have received this surgery can get dehydrated, and can be low on vitamins and minerals if not taking supplements. 

Lap Band- this is a minimally invasive technique that is just as the name implies, a band placed inside the body to lessen the size of the stomach
Gastric Balloon- a newer procedure that is done under local anesthesia, it is a balloon that occupies space in the stomach, giving a feeling of full. The balloon must be removed after 6 months.

The options for bariatric surgery are more today than ever before. Considering that weight loss is a multibillion-dollar industry each year, its no surprise weight loss surgery is very popular. Most are performed safely and with no complications, however occasionally there are complications and a patient must be admitted for follow up care.

A Patients Experience

A 34-year-old female that weighed 298 pounds decided to have weight loss surgery. Based on her age and lifestyle, the doctor determined the lap band would be her best option. She had the surgery, and at first things seemed ok. Two months after the surgery she began to worry about how bad she felt all of the the time. The doctor determined the band was leaking the fluid within into her system. The band had to be removed and the patient began to feel better, proving what she assumed to be true, the band is what was causing the problem. The patient was malnourished and dehydrated and was hospitalized for 4 days due to her condition. She later decided to have the gastric sleeve surgery, which was a complete success. She was able to lose weight and suffered no complications. Her only advice would be to research what procedure you plan to have and ask many questions. 

Most weight loss surgeries turn out fine, however not all. Patients may suffer complications, and could end up hospitalized and in need of treatment. 

Skin Removal

Often after weight loss surgery, skin removal becomes necessary. Skin removal can be very invasive, and can take months to heal completely.  Patients that have undergone this type of surgery will usually remain hospitalized for several days. They will need to be monitored closely for infection, which can be detected through fever, pain, redness, or swelling. Patients may require pain medications during their healing process for the areas the skin was removed from. Patients should have their surgical sight monitored closely for signs of infection.

Bariatric surgery is generally well tolerated, however like any surgical procedure, there can be complications. Most bariatric patients are searching for an answer to a problem they have lived with for a number of years.  Some bariatric patients say there is essentially nothing they will not do to finally gain control of their weight problem. Fortunately, most surgeries for bariatric conditions turn out well, and the only treatment the patient will need is follow up treatment and close monitoring until the area has healed. Patients will then need to be monitored to ensure they are maintaining a healthy weight, and to ensure lab results are within normal range.

When providing care for a post surgical bariatric patient, they should be congratulated on taking a step to ensure better health for themselves. Routine monitoring of a post surgical patient generally takes place over the course of 6 months to 1 year, and then periodic checkups. As the nurse involved in the patients care, you will play a supportive role in their recovery. Offer encouragement, and support, as the patient has taken a very big step in gaining control of their problem. 


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