ORIGINAL CONTRIBUTIONS The Peri-operative Bariatric Surgery Care in the Middle East Region Abdelrahman Nimeri 1,2 & Mohammed Al Hadad 3 & Mousa Khoursheed 4 & Ahmed Maasher 1,2 & Aayed Al Qahtani 5 & Talat Al Shaban 1,2 & Hayssam Fawal 6 & Bassem Safadi 7 & Amer Alderazi 8 & Emad Abdalla 9 & Ahmad Bashir 10 # Springer Science+Business Media New York 2016 Abstract Background Bariatric surgery is common in the Middle East region. However, regional accreditation bodies and guidelines are lacking. We present the current peri-operative practice of bariatric surgery in the Middle East region. Setting Public and private practice in the Middle East region. Methods A questionnaire was designed to study trends of peri-operative care in bariatric surgery. It was sent to members of the Pan Arab Society for Metabolic and Bariatric Surgery (PASMBS). Results Ninety-three surgeons (88.6%) responded, 63.4% were in private practice, 68.5% have been in practice for more than 5 years, and 61.1% performed more than 125 cases per year. Laparoscopic sleeve gastrectomy (LSG) was the commonest procedure performed, then laparoscopic Roux- en-Y gastric bypass (LRYGB), one anastomosis gastric bypass/mini gastric bypass (OAGB/MGB), and laparoscopic adjustable gastric banding (LAGB). Pre-operatively as a rou- tine, 65% referred patients for dietitian and (78.3%) for smoking cessation. In contrast as a routine, 22.6% referred patients to a psychologist, 30% screened for obstructive sleep apnea (OSA), and when they did, they did not use a question- naire. For patients 50 years of age, 22% performed a screening colonoscopy and 33.7% referred patients to a cardiologist. Intra-operatively as a routine, 25.3% placed a drain and 42.2% placed urinary catheters. In contrast, 77.1% performed a leak test (82.7% as a methylene blue leak test). Post-opera- tively, 79.5% used chemoprophylaxis for venous thromboem- bolism and 89% required patients to take vitamins. In contrast, 25% prescribed ursodeoxycholic acid. Conclusion The wide variation in the peri-operative care of bariatric surgery in the Middle East region highlights the need for regional guidelines based on international guidelines. Keywords Peri-operative . Bariatric surgery practice . Middle East Introduction The Pan Arab Society for Metabolic and Bariatric Surgery (PASMBS) includes surgeons practicing in the Arab- speaking countries in the Middle East and Africa. Many coun- tries in the Middle East and Africa do not have established national bariatric surgery societies. In addition, many are not members of the International Federation for Surgery of Obesity (IFSO). The burden of obesity, type II diabetes, and the metabolic syndrome in these countries has reached alarming levels in the last two decades [1]. In addition, the number of bariatric surgery procedures performed has in- creased as well [2]. In contrast, based on our monthly WebEx Tele-video meeting, most bariatric surgeries * Abdelrahman Nimeri Nimeri@gmail.com 1 Bariatric and Metabolic Institute Abu Dhabi, Sheikh Khalifa Medical City, Abu Dhabi, UAE 2 Division of General, Thoracic and Vascular Surgery, Sheikh Khalifa Medical City, Abu Dhabi, UAE 3 Dr Hadad Health Point Hospital, Abu Dhabi, UAE 4 Kuwait University, Kuwait City, Kuwait 5 King Saud University, Riyadh, Saudi Arabia 6 Makassed General Hospital, Beirut, Lebanon 7 American University of Beirut Medical Center, Beirut, Lebanon 8 Sulaimania Medical Complex, Beirut, Lebanon 9 Mansoura University, Mansoura City, Egypt 10 Jordan Hospital, Amman, Jordan OBES SURG DOI 10.1007/s11695-016-2503-7