Enhancing bariatric surgery safety for patients refusing blood transfusions: a specialized protocol with...

Area of Science:

• Bariatric Surgery
• Minimally Invasive Procedures
• Patient Safety

Background:

• Bariatric surgery is a key treatment for obesity, with Laparoscopic Sleeve Gastrectomy (LSG) and Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) showing success.
• Jehovah's Witnesses' refusal of blood transfusions presents unique challenges for bariatric surgery, a topic rarely addressed.

Purpose of the Study:

• To investigate the safety and efficacy of bariatric surgery in patients refusing blood transfusions.
• To evaluate a specific protocol designed to minimize bleeding risk during these procedures.

Main Methods:

• Prospectively collected data from 11 Jehovah's Witness patients undergoing bariatric surgery (2019-2023) were reviewed.
• A protocol focused on bleeding prevention was implemented, including preoperative iron treatment for anemia and tranexamic acid use.
• Data analyzed included operative details, blood loss, complications, and hemoglobin levels.

Main Results:

• No intraoperative or major postoperative complications occurred in the 11 patients (10 LSG, 1 LRYGB).
• All patients maintained stable hemodynamics; only one experienced minor nausea-vomiting.
• One patient had minimal hemorrhagic drainage, resolving with tranexamic acid.

Conclusions:

• Bariatric surgery can be performed safely in patients who refuse blood transfusions.
• An established protocol is crucial for managing bleeding risks and ensuring successful outcomes in this patient population.