Although the sleeve gastrectomy does not result in as much weight loss as the duodenal switch or gastric bypass, it can be used as a stand-alone operation or as a bridge to more complex procedures in the high-risk super-obese patient.

Parathyroid hormone levels are increased in the morbidly obese and are positively correlated with BMI. Recognition of preoperative hyperparathyroidism is important because of the risk of attributing postoperative hyperparathyroidism to the effects of surgery. Further studies are needed to elucidate the cause of elevated PTH in these patients.

The risk of hyperparathyroidism after the duodenal switch operation is related to the length of the common channel.

This is an important and potentially fatal complication of bariatric surgery. Very obese male patients with prolonged surgery are at risk of gluteal muscle necrosis with consequent renal failure, which we hypothesize is due to pressure by the operating-table leading to rhabdomyolysis and the creation of a compartment syndrome. Prevention may be aided by attention to intraoperative padding and positioning, and by limiting the duration of the operation.

Moderate obesity does not affect the clinical and radiologic outcome of TKA. However, TKA results in improved mobility, enhancing the success of subsequent weight loss therapy.