Post-Bariatric Surgery Care in Israeli Adolescents: A Qualitative Study

Abstract

Undergoing bariatric surgery is a life-changing experience for adolescents. However, little is known about post-bariatric surgery management among Israeli adolescents. We aimed to identify the post-operative needs and support from a qualitative aspect. Seventeen adolescents who underwent bariatric surgery were interviewed by semi-structure telephone interview. The interview guide was validated by 10 content experts from different hospitals across the country. Data were collected in 2018. Analysis of the interviews revealed three major themes: “multi-disciplinary team management,” “patient satisfaction,” and “follow-up.” The “multi-disciplinary team management” theme was further divided into three major categories: “pain management,” “physiotherapy,” and “nutrition.” “Patient satisfaction” was further divided into “guidance” and “team handling” categories. The “follow-up” theme included recommendations for improvement. The analysis provides novel information about adolescents’ needs after bariatric surgery. Healthcare professionals’ awareness of the adolescents’ perspective could contribute to providing optimal post-operative care to this population.

What matters to adolescents with obesity, and their caregivers, when considering bariatric surgery or weight loss devices? A qualitative evidence synthesis

“…Eight of the 19 studies were considered to be supported by rich data scoring 4 or 5 on the richness scale, and five were deemed to be supported by moderately rich data scoring 3 31,32,34,40,41 . Data were assessed as meager for the surgery evidence in the remaining six studies 22,23,30,35,36,38 . Overall, therefore, the quality of the evidence base was good or very good, with 17/19 judged to be at either low or moderate risk to rigor, and 13/19 having very rich, rich, or moderately rich data.…”

“…31,32,34,40,41 Data were assessed as meager for the surgery evidence in the remaining six studies. 22,23,30,35,36,38 Overall, therefore, the quality of the evidence base was good or very good, with 17/19 judged to be at either low or moderate risk to rigor, and 13/19 having very rich, rich, or moderately rich data.…”

“…The type of surgery undertaken or proposed was often unspecified in these studies. However, where a procedure or device was specified, three studies considered only SG, 25,32,36 two studies both Laparoscopic Roux-en-Y Gastric bypass (LRYGB or RYBG) and SG procedures, 26,29,35 two studies LRYGB or RYGB only, 35,40 and three studies gastric band. [38][39][40] In terms of weight loss devices, one study considered experiences of an Endobarrier 38 and one study IGB.…”

“…29 In four studies, adolescents reported their experiences of pain, discomfort, and other complications, but most of these complications occurred principally during immediate post-surgery care. 33,36,38,42 In the longer-term, adolescents in one study noted how the surgery occasioned disruption to their life and affected their intimate relationships. 41 Finally, caregivers in one study reported on the logistical challenges and demands of service attendance for complications post-surgery.…”

Pediatric obesity and anesthetic challenges of metabolic surgery

“…[ 93 ] The medical team needs to perform adequate measures to scale pain intensity and restrain it by properly administering analgesics. [ 94 ] Besides this, the medical team should be attentive to the early postoperative period's comprehensive metabolic panel (CMP). [ 95 ] The multidisciplinary team may order CMP under preoperative comorbidities to diagnose any irregularities in basic blood tests following the bariatric surgery.…”