What are the preoperative preparations for bariatric surgery? Bariatric surgery is an effective treatment for moderate-to-severe obesity recognized by domestic and international clinical research in the last decade or so. However, due to the lack of multidisciplinary management of bariatric surgery in China, especially long-term nutritional management and monitoring, patients face malnutrition, regaining weight, and other problems after bariatric surgery. Indications 1. Weight loss surgery is feasible for patients with body mass index ≥37kg/m2, without comorbidities or serious associated risks. 2, Body mass index ≥32kg/m2, at least 1 serious obesity-related diseases in combination, including type 2 diabetes, hypertension, hyperlipidemia, obstructive sleep whistle pause (OSA), obesity hypoventilation syndrome (OHS), non-alcoholic fatty liver disease or non-alcoholic steatohepatitis, gastroesophageal reflux disease (GERD), bronchial asthma, severe urinary incontinence, severe arthritis or serious If the quality of life is affected, weight loss surgery can be considered. Patients with a body mass index of 28-32 kg/m2, combined with type 2 diabetes or metabolic syndrome may also undergo bariatric surgery, but there is limited evidence in this regard. 4. There is insufficient evidence that weight-loss surgery can be performed to control blood glucose and lipids or to reduce risk factors for cardiovascular disease without regard to body mass index. Preoperative assessment Obesity can lead to multi-system complications such as diabetes mellitus, hypertension, dyslipidemia, coronary artery disease, OHS, etc., which in turn affects the life expectancy of the patient or leads to a decrease in his/her quality of life. Therefore, the evaluation of complications in obese patients is an important part of the obesity diagnosis and treatment process. Obesity Preoperative differential diagnosis of obesity is required, and relevant endocrine metabolic assessment is completed. According to the etiology, obesity can be categorized into three major types: simple, secondary, and clinical syndromes caused by single gene defects or combined obesity. Simple obesity accounts for more than 95% of all obesity and requires the exclusion of possible secondary or hereditary factors before a diagnosis can be made. Secondary obesity is mainly secondary to endocrine metabolic diseases and drug factors; the former includes hypothyroidism, Cushing’s syndrome, hyperprolactinemia, hypogonadism, acromegaly, etc., and the latter includes glucocorticoids, antidepressants and anticonvulsants. Obesity due to single gene defects or combined clinical syndromes of obesity can be seen in disorders such as leptin gene defects, Prader-Willi syndrome, and Bardet-Biddle syndrome. After the diagnosis of obesity, an assessment of glucose metabolic status needs to be completed. It is recommended that fasting and 2-h postprandial glucose, insulin and C-peptide levels, as well as glucose tolerance tests be refined to adequately assess pancreatic β-cell function. The hyperglycemic clamp test is the gold standard for evaluating pancreatic islet function, but can be used as a research tool due to the complexity of its operation. In addition, evaluation of blood pressure, blood lipids, and blood uric acid levels should also be completed. Weight Loss Surgery “Sleeve Gastrectomy” Laparoscopic gastric reduction surgery, also known as Sleeve Gastrectomy (Laparoscopic Sleeve Gastrectomy), is based on the principle of using a laparoscope to cut the greater curvature of the stomach vertically, so that the stomach creates a small pouch of about 150cc, which can hold 4-5 ounces of food. hold 4-5 ounces of food. The advantage is that there is no need to place foreign objects in the body and the surgery is highly effective in weight loss. Method: The gastric sinus above the pylorus is preserved for 2-6cm in the direction of the greater curvature of the stomach, and along the long axis of the stomach, the large part of the stomach is resected, and all the fundus is removed, so that the remaining stomach is in the shape of a banana, with a volume of about 60-80ml. Principle: Reduce the volume of the stomach and decrease the secretion of hormones that stimulate hunger. Advantages: Does not change the physiological state of the gastrointestinal tract and does not interfere with the normal digestion and absorption of food. Evaluation: Sleeve Gastrectomy has a good therapeutic effect on type 2 diabetes and is now widely used in Europe for weight loss and diabetes surgery. Weight loss surgery can lose 60-80% of your excess weight, and the results will be even better if your post-operative dietary lifestyle and exercise habits are well-coordinated with the support and assistance of a professional health manager.