5
Manage Bariatric Devices Before and After Nonsurgical
Procedures
Preprocedural Medical Management
➤ Complete medical and nutritional assessment; correct vitamin
deficiencies before the procedure.
➤ Consider initiating a proton pump inhibitor and multivitamins.
➤ Counsel about preoperative smoking cessation to improve
outcomes.
➤ Screen for and treat obstructive sleep apnea.
➤ Conduct a psychological screening.
➤ Screen for other medical comorbidities, such as cardiac disease, to
ensure criteria are met for surgical intervention and anesthesia.
Postprocedural Medical Management
➤ Enroll patients in behavioral interventions and allied health
services at a bariatric surgical center.
➤ Monitor for adverse effects and offer symptomatic treatment such
as laxatives, antiemetics, antispasmodics, and analgesia.
➤ Ensure bariatric centers communicate a comprehensive plan to
primary care clinicians.
➤ After discharge from the care of the bariatric center, patients
need annual evaluation of weight, nutritional intake, activity,
adherence to multivitamin and mineral supplements, assessment
of comorbidities, and laboratory evaluation to assess and treat
nutritional deficiencies.
➤ Coordinate follow-up with the interprofessional healthcare team,
including a dietician, nurse, social worker, bariatric clinician,
surgeon, and psychologist or psychiatrist.
➤ Primary care clinicians should be educated on referral criteria,
such as for technical malfunction, gastrointestinal symptoms,
nutritional issues, pregnancy, psychological support, and
weight regain.
➤ Schedule removal of the balloon device in 6–12 months.
➤ Follow up for gastrointestinal adverse effects, such as
gastrointestinal reflux, constipation, diarrhea, nausea, and vomiting.
