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Metabolic and bariatric surgery: Selection and preoperative work-up
J G M Smit1, J Lubbe2, A Murphy3
1Obesity Health Centre, Zuid-Afrikaans Hospital, Pretoria; Department of Surgery, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
|December 11, 2025
Summary
Before bariatric surgery (MBS), patients should undergo medical and nutritional evaluations and be screened for sleep apnea. Quitting smoking before surgery can reduce complications.
Area of Science:
- Bariatric Surgery
- Medical Evaluation
- Nutritional Assessment
Background:
- Bariatric surgery (MBS) is a significant intervention for obesity.
- Patient selection and preparation are crucial for successful outcomes.
- Minimizing preoperative risks is essential for patient safety.
Purpose of the Study:
- To provide evidence-based recommendations for patient preparation before bariatric surgery.
- To identify key factors influencing postoperative complications.
- To guide clinicians in optimizing patient candidacy for MBS.
Main Methods:
- Systematic review of evidence.
- Grading of recommendations based on study level and grade.
- Synthesis of findings to formulate clinical suggestions.
Main Results:
- Comprehensive medical and nutritional evaluations are recommended for MBS candidates.
- Correction of nutrient deficiencies is advised.
- Screening for and treatment of obstructive sleep apnea is suggested.
- Preoperative smoking cessation is linked to fewer postoperative complications.
Conclusions:
- Optimizing patient health through medical, nutritional, and sleep apnea management improves MBS outcomes.
- Addressing modifiable risk factors like smoking is critical.
- These recommendations aim to enhance patient safety and surgical success.
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