Preparation for Surgery

What are the routine tests before surgery?

Certain  tests are done prior to surgery: these tests provide your bariatric surgeon with important medical information about your health status. Consultation with a with a psychologist/psychiatrist, primary care physician, cardiologist, pulmonologist, gastroenterologist, or an endocrinologist are a few examples.

What is the purpose of all these tests?
An accurate assessment of your health is needed before surgery. The best way to avoid complications is to never have them in the first place.
If you are diabetic, special steps must be taken to control your blood sugar. Because surgery increases cardiac stress, your heart will be thoroughly evaluated. These tests will determine if you have liver malfunction, breathing difficulties, excess fluid in the tissues, abnormalities of the salts or minerals in body fluids, or abnormal blood fat levels.

Why do I have to have a GI Evaluation?
Patients who have significant gastrointestinal symptoms such as upper abdominal pain, heartburn, belching sour fluid, etc., may have underlying problems such as a hiatal hernia, gastroesophageal reflux or peptic ulcer. For example, many patients have symptoms of reflux,, which could predispose them to cancer of the esophagus. It is important to identify these changes so a suitable surveillance or treatment program can be planned.

Why do I have to have a Sleep Study?
The sleep study detects a tendency for abnormal stopping of breathing, usually associated with airway blockage when the muscles relax during sleep.
It is important to have a clear picture of what to expect with a patients airway prior to undergoing bariatric surgery. 

Why do I have to have a Psychiatric Evaluation?
A psychiatric or behavioral evaluation is needed to evaluate your understanding and knowledge of the risks and complications associated with weight loss surgery and your ability to follow the basic recovery plan. The evaluation also helps the patient to identify support systems presently in place to make the very important lifestyle changes that are necessary for both short term and long-term weight loss. 

What impact do my medical problems have on the decision for surgery, and how do the medical problems affect risk?
Medical problems, such as serious heart or lung problems, can increase the risk of any surgery. On the other hand, if they are problems that are related to the patient's weight, they also increase the need for surgery. Severe medical problems may not dissuade the surgeon from recommending surgery if it is otherwise appropriate, but those conditions will make a patient's risk higher than average. Consultation and or clearance from a specialists maybe requested.

If I want to undergo one of the bariatric surgeries, how long do I have to wait?

Many factors are involved once a patient has decided to proceed with bariatric surgery. The first step is to confirm bariatric surgery is a covered benefit under your specific insurance plan. The next step is a consultation with the bariatric surgeons program. Surgery may occur within 2 to 6 months as this will depend upon the individual’s readiness for lifestyle changes and the individual’s insurance company’s criteria.   

What can I do before the appointment to speed up the process of getting ready for surgery?

  • Select a primary care physician if you don't already have one, and establish a relationship with him or her. Work with your physician to ensure that your routine health maintenance testing is current. For example, women may have a pap smear, and if over 40 years of age, a breast exam. And for men, this may include a prostate specific antigen test (PSA).

  • Make a list of all the diets you have tried (a diet history) and bring it to your doctor.

  • Bring any pertinent medical data to your appointment with the surgeon - this would include reports of special tests (echocardiogram, sleep study, etc.)

  • Bring a list of your medications with dose and schedule.

  • Stop smoking. Surgical patients who use tobacco products are at a higher surgical risk.