Care of the patient with superobesity requires special precautions and appropriate equipment. Recently, we performed bariatric procedures (modified very-long-limb Rouxen-Y gastric bypass) on patients weighing 355 kg and 377 kg. These procedures required preoperative preparation concerning safe means of transport of the patient, techniques of anesthesia and intraoperative exposure, provisions for postoperative recovery, and measures to assure patient comfort and hygiene postoperatively. In addition to specially designed bariatric procedures for the superobese, specialized equipment is needed to protect the health of the patient and the staff. All health care providers and especially acute care centers must have preconceived protocols to treat the superobese patient. In addition, specialized equipment is necessary to allow safe transport and support of these patients.