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Related Experiment Video

Updated: Nov 27, 2025

Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion
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Intraoperative decision making in bariatric surgery.

Ahmad Al Samaraee1, Akeil Samier1

  • 1Department of General & Bariatric Surgery, Darlington Memorial Hospital, Darlington, UK.

Qatar Medical Journal
|December 7, 2020
PubMed
Summary

Unexpected findings during bariatric surgery require critical intraoperative decisions, sometimes leading to procedure abandonment or conversion to laparoscopic sleeve gastrectomy. This review highlights these rare but challenging scenarios for surgeons.

Keywords:
bariatric surgerydecision makingintraoperative challengesmetabolic surgeryweight loss surgery

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Area of Science:

  • Bariatric Surgery
  • Surgical Decision-Making
  • Anatomical Variations

Background:

  • Unexpected intraoperative findings can occur during bariatric surgery.
  • These findings necessitate prompt, critical decisions not planned preoperatively.
  • This review shares experiences with intraoperative challenges in bariatric procedures.

Purpose of the Study:

  • To present experiences with unexpected intraoperative findings in bariatric surgery.
  • To share knowledge on managing these challenges with surgical colleagues.
  • To focus on applied learning and practical value in intraoperative decision-making.

Main Methods:

  • Single-center retrospective review of bariatric operations.
  • Analysis of patients with unexpected intraoperative findings despite detailed preoperative evaluations.
  • Comparison of intended procedures (Roux-en-Y gastric bypass) with actual outcomes.

Main Results:

  • Eleven patients (2.4%) out of 449 met inclusion criteria.
  • Mean age was 40.82 years; 63.6% were female; mean BMI was 40.8.
  • 81.1% underwent laparoscopic sleeve gastrectomy instead of Roux-en-Y gastric bypass; 18.9% had surgery abandoned. No perioperative morbidity or mortality.

Conclusions:

  • Intraoperative decision-making for unexpected findings in bariatric surgery is complex.
  • Surgeons must make critical, prompt decisions, including potentially abandoning surgery.
  • Literature on this topic is limited due to the rarity of such events.