Memorial Hermann-Texas Medical Center

Weight Loss Surgery (Bariatrics)

Preparing for Bariatric Surgery

Preparing for bariatric surgery actually begins long before you come to Memorial Hermann-Texas Medical Center. You'll participate in a series of meetings, conferences and pre-admission tests and be asked to take on some responsibilities yourself, including:

Free Informational Seminar Conference with Surgeons Pre-op procedures What You Can Do What To Bring Day Of Your Surgery Insurance

It’s all designed to ensure that when the day of your surgery arrives, you’ll be ready and in the best possible condition for a fast, healthy recovery. And it’s another reason why Memorial Hermann’s bariatric success rate far exceeds the national average.

Free information Seminar

The first step in your preparation is a free informational seminar. It's a great way to learn about Memorial Hermann-Texas Medical Center, our bariatric surgeons, and the different surgical techniques available.

By the end of the seminar, you will understand how the surgery is performed, the risks and benefits, and which surgery is right for you. Attending one of these seminars is a requirement before you can have surgery.

At this meeting, we'll also give you some advice on getting the process started. This includes the necessary preliminary tests – psychological and nutritional evaluations – as well as others you may need, such as:

• Glucose tolerance test, which is often done to determine if a patient has diabetes, a common condition among obese individuals
• Gallbladder ultrasound to look for gallstones
• Basic tests done prior to any surgery, such as complete blood count, urinalysis and blood chemistry
• A variety of other tests (pulmonary function, echocardiogram, electrocardiogram, sleep studies, gastrointestinal evaluation) that may be conducted at your surgeon's request

Conference with Surgeons

Up to 12 weeks prior to surgery, you’ll meet with your surgeon. During this conference, you and your doctor will discuss the results of any tests that have already been taken.

In some cases, this first round of results may indicate other conditions. If that’s the case, surgeons may order additional tests – and perhaps even a third round – in order to have the most comprehensive medical information possible.

This exhaustive testing process is important for two reasons. First, it will help determine if bariatric surgery is the right option for you. Second, it will help identify potential health problems and reduce the risk of complications.
   

Pre-Op procedures

The final stage of preparation begins about two weeks before surgery, when you’ll come to the hospital for a number of standard practices and procedures:

• You’ll complete pre-admission paperwork
• You will have blood drawn
• You and your anesthesiologist will meet to discuss that aspect of your surgery and how you should prepare

Also at this time, surgeons will review the results of any more recent tests and determine if any further corrective measures are necessary.

What You Can Do

In addition to undergoing the pre-admission testing, there are a number of steps you can take that will maximize the likelihood of a successful surgery:

• Avoid pain-relief and blood-thinning drugs. Aspirin, ibuprofen and the blood thinners Coumadin and Plavix can cause increased bleeding during surgery.
• Stop smoking. If you smoke, you should stop at least a month – and preferably two – before surgery.
• Exercise. Try to get some physical activity, even if it's just a daily walk. Every little bit helps.
• Lose weight. Although bariatric surgery is designed to help you lose a lot of weight, shedding a few pounds before the procedure is a good idea. It shows your commitment and can help minimize the potential for complications.
• Listen to your doctors. They will provide expert advice on a full range of topics – from dieting to exercise programs – that's in your best physical, mental and surgical interests.

What To Bring

When coming to Memorial Hermann-Texas Medical Center for bariatric surgery, be sure to bring all your insurance and medical information as well as your Medicare or Medicaid card, if appropriate.

There are also a variety of personal items you can bring from home that will make your stay more comfortable, including:

• Bathrobe
• Slippers
• Shampoo
• Body lotion or hand cream
• Scented soap
• Toothbrush and toothpaste
• Loose-fitting clothes
• Books and magazines

The Day Of Your Surgery

Typically, you’ll arrive at Memorial Hermann-Texas Medical Center the morning of your procedure. At that time, you will change into a hospital gown, a catheter will be inserted into your vein, and you’ll get any medications that might be required before surgery.

Additionally, you will have a consultation with your anesthesiologist. After that, you’ll be taken to the Operating Room for the surgery. Depending upon the type of procedure and whether your surgeon uses an open or laparoscopic approach, the operation can take between one and three hours.

When the surgery is over, you will be moved to the recovery room until you wake up, which can take from 1½ to three hours. While in recovery, compression sleeves will be placed on your legs to promote circulation and prevent blood clots.

From there, you’ll be moved to a post-operative room, where you’ll stay until being discharged by your doctor. Food and pain medication will be administered through an IV line. The pain medicine, which you’ll control with a pump, will let you cough, take a deep breath, and move around – but won’t promote too much sleep.

Within a day or two of the surgery, X-rays will be taken to assess the gastric pouch and check for any leaks. If, as expected, there are no leaks, you can have one ounce of clear liquid every 15 minutes. Also, the catheter and compression devices will be removed.

Depending upon the procedure and technique, you can expect to be hospitalized anywhere from one to five days. Although your intake of liquids will increase as you recover, you can expect to stay on a liquid diet until your doctor evaluates your condition, usually a week or 10 days after you've gone home.

Insurance

If you're a qualified bariatric patient, insurance will often pay the costs of the surgery and hospitalization. Although coverage generally ranges from 50 to 100 percent of the total, the amount – and whether you are covered – depends on your policy.

Given that plans can vary, it is important to familiarize yourself with your:

• Insurer's medical review process
• Levels of coverage
• Deductibles
• Co-payments

It is also important to note that getting approval from insurers for bariatric procedures can take some time – three to four weeks or even longer – and that companies may try to exclude you based on a lack of “medical necessity.”

So it's important to work closely with your doctor from the start to get the documents, evaluations, and letters necessary to secure quick approval.