Infrastructure and human resources

Requirements for clinics wanting to successfully perform bariatric surgery are high. In addition to infrastructure, the required staff resources are considerable. This is due to the specific nature of massive overweight, which goes along with a specific variety of risks requiring careful management during the informational phase, preparation and realisation of the surgical procedure, and during the longest phase – the postoperative follow-up.

Surgical team:
- visceral surgeons with appropriate laparoscopic experience
- bariatric experience and advanced training (cp. Tab.10)
- surgical emergency department (stand-by service) with surgeons familiar with diagnostics and treatment of complications on call.
Providing adiposity consultation:
- patient selection, information, management of diagnosis and treatment
- special scales, bio-impedance analysis, ultrasound
- documentation (obesity register, clinical reports, insurance correspondence)
- follow-up, band adjustment, blood analysis
- X-ray equipment with picture amplifiers for band adjustment
- prospective data recording
- photo lab
Nutritional counselling
For patient selection as well as for further consultation before and after surgery, it is absolutely essential to provide guidance by a team of nutritional counsellors experienced in massive overweight and bariatric surgery.
Interdisciplinary support:
A full range of diagnostic and consulting resources must be available: This mainly means effective cooperation with the following specialised institutions:
- Gastroenterological clinic (stomach and bowel diseases)
- Cardiology clinic (heart disease)
- Pulmonary clinic (lung disease)
- Radiological institute
- Psychiatric dept.
Anaesthetic team:
- well experienced in handling of morbid obese people
IC-Unit:
- delayed extubation, mechanical ventilation
- management of complications
Operating facilities:
- operating table (loading capacity > 250kg)
- transportation, positioning
- laparoscopic instruments and technical equipment
Wards:
- Specific requirements of massive overweight patient care