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

3. SURGICAL PERSPECTIVE Challenges in obese patients

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

6. Surgical Tracheostomy

8. Radiology

13. In the OT

18. In the ward

21. Nursing

22. BENCHMARK ? Challenges in bariatric surgery

34. 2007 THE IDEA

37. الحل الطبيعي

38. الحل المثالي

39. 33 CASES 2009

40. Drawback Surgeon Anaesthesia Follow up

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

42. 32 CASES 2010

43. 65 CASES 2011

44. 140 CASES 2012

45. 2013 33 cases

46. 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%

48. subanalyisis

51. Major cases 9 CASES BMI> 70 20 REVISIONAL SURGERIES 18 CASES BMI>60 103 SUPER OBESE.

52. Major complication Total patients 303 -20=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%

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