Rashid Hospital bariatric Success story Narrated by Dr Ali Khammas MD (sweden),Swedish Board

SURGICAL PERSPECTIVE Challenges in obese patients

anaesthesia BMI and complication Comorbidities ( need for mechanical vent ) Airway Vascular access BP cuff Medication Post op pain

Surgical Tracheostomy

Radiology

In the OT

In the ward

Nursing

BENCHMARK ? Challenges in bariatric surgery

2007 THE IDEA

الحل الطبيعي

الحل المثالي

33 CASES 2009

Drawback Surgeon Anaesthesia Follow up

New strategy Multi disciplinary approach Anesthesia Dietician Psyckologist Plastic surgeon Physician Guideline.

32 CASES 2010

65 CASES 2011

140 CASES 2012

cases

Major complication Total patients 303 Death 0 0% Leaks 4 1,3% Reoperation 5 1,6% Bleeding 3 0,99% Abscess 2 0,6% Stenosis 1 0,33% P embolism 0 0% Int obstruction 0 0% Total 15 4,95%

subanalyisis

Major cases 9 CASES BMI> REVISIONAL SURGERIES 18 CASES BMI> SUPER OBESE.

Major complication Total patients =283 Death 0 0% 0% Leaks 4 1,3% -3=1 0,35% Reoperation 5 1,6% -3=2 0,7% Bleeding 3 0,99% 3 1% Abscess 2 0,6% -1=1 0,35% Stenosis 1 0,33% 1 0,35% P embolism 0 0% Int obstruction 0 0% Total 15 4,95% 8 2,8%

Contributors to success TEAM WORK. NAGGING ANAESTHESIA ADHERENCE TO POLICY MULTI DISCIPLINARY APPROACH