LAUSR

Editor An interesting issue, focusing on ‘advances in perioperative care’, has recently been published by two leading journals, BJS and Anaesthesia, in the fields of surgery and anaesthesia. The timing of this event was welcomed because it demonstrated the importance of collaborations between surgery and anaesthesia, which are regularly experienced during daily practice1. The accompanying Editorial1 emphasizes the necessity that surgeons and anaesthetists learn to work together in a skilled team to best ensure the efficacy and safety of perioperative approaches to surgical patients, with the aim of improving outcomes1–4. Several examples of these types of collaborations have been reported1. The perioperative management of morbidly obese patients represents a good opportunity to practice cooperation between surgeons and anaesthetists in clinical practice1, which is essential when treating high-risk surgical patients5. In our hospital, ‘perioperative care of the obese patient’5 represents an active and effective approach. Since its implementation, 2830 morbidly obese adult patients (2206 females and 624 males), after careful preparation, have undergone consecutive weight-loss-related surgical procedures (2130 laparoscopic sleeve gastrectomies, 476 laparoscopic adjustable gastric banding procedures, 207 laparoscopic gastric bypasses and 17 laparoscopic duodenal switch procedures) under inhalational anaesthesia. Multimodal analgesia, adequate neuromuscular blockade management, proper ventilatory strategies, and accurate fluid and temperature management were adopted5. All patients were managed by a skilled team, discharged to a surgical ward soon after surgery for early ambulation (generally within 3–4 h), and discharged from the hospital within