Bariatric surgery: Early results with a multidisciplinary team

Background: Bariatric surgery depends on complete preoperative study of mor bid obesity, in order to obtain the treatment of choice, A multidisciplinar y group was founded in 1998 at the University of Siena. Methods: During 1998, 16 patients, with median weight 121.8 +/- 31 kg and m edian body mass index (BMI) 43 +/- 6, underwent bariatric surgery. A multid isciplinary assessment was used in order to evaluate psychological status, food intake problems and patient compliance, and hemodynamic, respiratory, metabolic and arthritic functions, 13 patients were submitted to laparoscop ic surgery: in 11 adjustable gastric banding was performed and 2 were submi tted to a vertical gastroplasty plus adjustable gastric banding. Three pati ents were operated via traditional laparotomy, due to previous abdominal su rgery in 2 cases (submitted to an adjustable gastric banding) and one woman was submitted to a bilio-intestinal bypass according to the Hallberg techn ique, for her psychiatric troubles and coexisting systolic hypertension and uncontrolled diabetes. Monthly follow-up for each patient continues after 6 months. Results: No morbidity or mortality has occurred. The median weight loss at three months, was 19.5 kg. Two cases required injection of 1 ml more of flu id into the port, respectively at 4 and 9 months. Fifteen days after surger y, seven patients (46%) had vomiting episodes, due to rapid food intake. Al l patients have shown an improvement of their comorbidities after surgery. Conclusion: Early results via the multidisciplinary team and laparoscopic b anding have been satisfactory thus far.