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Long-Term Management
Postoperative Long-Term Management
Follow-Up Schedule
➤ First year: Visits at 1 week, 1 month, 3 months, 6 months, 9 months,
and 12 months postoperatively.
➤ Two years and beyond: At least annual follow-up, with more
frequent visits for high-risk patients.
Nutritional Monitoring
➤ Lifelong vitamin and mineral supplementation is required,
especially after malabsorptive procedures such as RNYGB, BPD/
DS, and SADI-S. Routine laboratory testing surveillance includes:
• Complete blood count, iron studies, vitamin B12, folate, vitamin D,
calcium, parathyroid hormone, and fat-soluble vitamins (A, E, K).
• Additional testing for thiamine, zinc, copper, and selenium as
clinically indicated.
Bariatric Surgery: Common Micronutrient Deficiencies.
Vitamins Minerals
A B1 B9 B12
D
a
E K Ca Fe Zn/Cu
RNY
× × × × × ×
VSG
× × × × ×
LAGB
× ×
BPD or SIPS/SADI-S
× × × × × × × × × ×
a
Vitamin D deficiency is seen in a significant number of patients with obesity at baseline. However,
due to malabsorption, the risk is further increased postoperatively.
