Just as bariatric bypass surgery (sometimes called gastric surgery) is not an instant fix for weight problems, neither is the pre-operative process for the surgery instant. Several tests and consultations will need to be completed before your surgery will be scheduled and performed. Although certain consultations are necessary for everyone, additional consultations might be called for as the medical team considers the individual patient's state of health. The Mount Sinai School of Medicine's Program for Surgical Weight Loss provides a roadmap of what preoperative procedures will be needed.
Meet with the surgeon
Meet with a bariatric surgeon to discuss your health and options. According to National Institutes for Health criteria, bariatric bypass can be considered for people with a body mass index of more than 40, or more than 35 if the patient has serious medical problems, such as diabetes, obstructive sleep apnea or joint problems, that could be improved with weight loss. Several different surgical techniques have been developed and the surgeon will review your health and previous weight-loss efforts to decide which is best for you. How much weight needs to be lost is also a factor in this decision. As part of evaluating your total health picture, blood tests will be ordered. Some surgery centers request the blood testing be done before the initial meeting with the surgeon.
Meet with a nutritionist
Meeting with a nutritionist is standard procedure for bariatric bypass. Your diet will be different both before and after surgery. A nutritionist will explain what changes you'll need to make, as well as make sure you understand maintain the needed diet to maximize the benefit of the surgery. According to UpToDate.com, some patients need to lose a small amount of weight before surgery. Mount Sinai states that losing weight before surgery shrinks the liver and makes the operation safer.
Meet with a mental health professional
Both for insurance purposes and to help identify lifestyle, coping and stress issues, you will need to meet with a psychologist or psychiatrist before your surgery. A psychiatric evaluation is a standard pre-operative procedure.
Consult other specialists as the surgeon requests
Depending on what other medical conditions you may have, the surgeon may ask you to be examined by a cardiologist, sleep medicine specialist, pulmonologist or internal medicine specialist.
Start your pre-surgery diet
Follow the pre-surgery diet the nutritionist and surgeon recommend for you. Depending on the specific surgical technique selected for you and how much weight you need to lose before surgery, you will start your pre-surgical diet two weeks to three months before. The diet will be high in protein but low in fats, calories and carbohydrates. Some surgeons require a liquid protein diet for two weeks before surgery. You will also need to take vitamin supplements, avoid alcohol, stop smoking and avoid certain medications (your surgeon will tell you which ones to avoid). Mount Sinai recommends clear liquids only for two days before surgery in order to allow all solids to pass the small intestine.
The day of surgery
Starting at midnight before the surgery, you are allowed no fluid or food by mouth. You can take medications only and just a sip of water to swallow them. Your surgeon will tell you which medications to take and whether you should skip any of them on that day. Arrive at the designated time, which allows you to meet with the anesthesiologist, have an I.V. placed and be given medication to help you relax before surgery. Generally you will also be given an antibiotic and an anticoagulant to prevent infection and thrombosis.
