Multidisciplinary Management of Sleeve Gastrectomy

Sleeve gastrectomy is currently the most commonly performed bariatric procedure worldwide. Despite being classified as a restrictive procedure, it has been shown that its effects go beyond simple gastric volume reduction, involving hormonal and biochemical changes associated with the procedure. In addition, there is growing evidence of changes induced in the patient's previous dysbiosis. Beyond the pathophysiological aspects, this work aims to update the results obtained after performing this procedure, with current evidence from long-term data.

However, the most relevant aspect of the book is the multidisciplinary treatment of the disease, in which multiple specialists must participate in a coordinated manner to improve the results of the procedure. Therefore, multiple specialists from different medical and non-medical disciplines (nursing, physiotherapy, sports science, psychology) have participated in this book, providing a comprehensive overview of the treatment of patients undergoing sleeve gastrectomy. In line with this, specific mention is made of ERAS protocols, which have been applied to sleeve gastrectomy and have proven to be effective and safe, reducing post-operative complications and improving recovery and the perception of quality of life and the quality of healthcare provided.

The book is structured into 27 chapters, divided into four sections: preoperative assessment, intraoperative procedure, postoperative evolution, and mechanism of action of sleeve gastrectomy and challenges. The aim of this book is to provide a comprehensive overview of sleeve gastrectomy for the various specialists currently involved in its management.

Part I: Preoperative evaluation.- 1. Preoperative information of the patient and psychological suitability.- 2. Selection of patients for sleeve gastrectomy. Indications and contraindications.- 3. Nutritional optimization.- 4. Physical Prehabilitation.- 5. Upper Digestive Endoscopy and Screening of Helicobacter pylori Infection.- 6. Pneumological evaluation.- 7. Preoperative nursing evaluation.- Part II: Intraoperative procedure.- 8. Surgical Technique.- 9. Anesthetic considerations for patients undergoing sleeve gastrectomy.- 10. Revisional Surgery.- Part III: Postoperative course.- 11. Early postoperative complications.- 12. Critical care in the patient undergoing sleeve gastrectomy.- 13. Diet progression and lifestyle modification.- 14. Weight Loss and Remission of Comorbidities After Sleeve Gastrectomy.- 15. Challenges and Long-Term Complications of Sleeve Gastrectomy.- 16. Nutritional sequelae and specific supplementation requirements.- 17. Impact of physical activity on postoperative outcomes.- 18. Follow up schemes and role of the General Practitioner.- 19. Nursing involvement in the postoperative follow up.- 20. Postoperative quality of life.- 21. Economic Impact of Multidisciplinary Management of Sleeve Gastrectomy.- Part IV: Mechanism of action of sleeve gastrectomy and challenges.- 22. Hormonal and biochemical changes after sleeve gastrectomy.- 23. Impact of microbiota on the outcomes of sleeve gastrectomy.- 24. Enhanced Recovery After Surgery (ERAS) protocols.- 25. Sleeve gastrectomy in Pediatric and Adolescent Population.- 26. Sleeve Gastrectomy in the Elderly.- 27. Nissen sleeve: a modified procedure for treating severe obesity and gastroesophageal reflux disease.

Jaime Ruiz-Tovar, MD, PhD, is a General and Digestive Surgeon, a specialist in Bariatric Surgery, and is accredited as an Expert by the Spanish Society of Obesity Surgery. He is a Senior Professor of Health Sciences at Alfonso X University, Madrid, Spain, and the Director of the Master's Program in Bariatric Surgery Updates at TECH University.

He has been an active researcher in various aspects of sleeve gastrectomy over the past decade. He currently leads several research projects focused on obesity and translational studies involving microbiota and probiotics.