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Tests and visits before surgery


Weight-loss surgery is also called bariatric surgery. It is a procedure that involves you and a team of health care providers, not just a surgeon. Besides your surgeon, this team includes a nutritionist (or dietitian), a nurse, a mental health counselor, and others.

You will meet with all of these providers at different times before your surgery. You will talk with them about nutrition, exercise, smoking cessation (if needed), preparing for surgery, and life after surgery.

You may also be asked to attend classes about weight loss and weight-loss surgery.

Mental health assessment

You will be asked to talk with a mental health provider about why you want to have weight-loss surgery. You will discuss whether you are prepared to change your diet and exercise routines before and after surgery. You may also talk about what type of support you have and whether you will have enough support to help you both physically and emotionally before, during, and after your surgery.

Talking with this counselor will help you explore and identify problems such as substance abuse, depression, how you cope with stress, or just ways that you think about your health and health care. The goal is to help give you a better chance for success after surgery.

Your hospital or doctor's office may already have a counselor on their team, or you may be referred to one. It is important to see someone who has training in counseling patients about bariatric surgery. Even if you already see a therapist, you will usually have a separate psychological assessment by someone recommended by your bariatric team.

Tests before surgery

Almost all weight-loss programs and surgeons will require many tests before surgery. Some of these tests are for all patients. Others will be done only if you have risk factors for certain health conditions.

To make sure that a medical problem that could be treated is not the cause of your weight gain, your surgeon may order these tests:

  • Thyroid stimulating hormone (TSH)

Most weight-loss surgery programs and surgeons will ask you to have or be up to date on these screening tests:

  • Blood tests, including a complete blood count (CBC), kidney and liver tests, electrolytes, and blood sugar
  • Chest x-ray
  • Electrocardiogram (EKG)
  • Mammogram and Pap test, for women

Some programs or surgeons may also ask you to have these tests:

  • Upper endoscopy or swallowing test (an upper GI)
  • An ultrasound of your liver and gallbladder
  • Colonoscopy or sigmoidoscopy
  • Echocardiogram, heart stress test, or cardiac catheterization
  • Pulmonary (lung) function tests

Visits with other doctors

You may already have other health conditions, such as heart disease or diabetes. You may have risk factors for these or other conditions. Either way, your surgeon will want to know that none of these will cause any problems during your weight-loss surgery. Because of this, you may need to visit one of these doctors:

Cardiologist (heart doctor) -- if you:
  • Are older than 55
  • Have a history of heart problems (or have close relatives who do)
  • Are a smoker, have high blood pressure, or have diabetes
  • Are so out of shape that you cannot walk up a flight of stairs
Gastroenterologist (doctor who treats diseases of the digestive tract) -- if you have:
  • Had stomach, small intestine, or esophagus surgery
  • Severe reflux, heartburn, or a hiatal hernia
Diabetes specialist -- if:
  • You have diabetes already
  • Your blood-sugar screening test is high

Sleep doctor -- if you are having any symptoms of obstructive sleep apnea (stopping breathing when you are asleep)

Hematologist (doctor who treats blood disorders) -- if you have:

  • A history of blood clots
  • Close relatives who have had blood clots

Most likely, your surgeon will want a letter from these doctors stating that it is safe for you to have bariatric surgery.

Pre-operative physical

Before your surgery, you will need to have your medical history taken and a physical exam done.

  • This may be done by your surgeon, or you may be asked to see your primary care doctor.
  • Try to have this checkup well before your surgery. That will give your doctors time to treat any of your medical problems before surgery.
  • If you see your primary care doctor for your medical history and physical exam, make sure your hospital or surgeon has these reports. Your surgeon should also have your recent lab test, EKG, and chest x-ray results.

Some hospitals will also ask you to meet with a hospital nurse or anesthesiologist during the week before your surgery.

  • The nurse will ask you many questions about your medical history.
  • You may also have a chest x-ray, some lab tests, or an EKG during this visit.

You may be asked the same questions by many different people before your surgery. It is important for your surgery team to have all the information they need to ensure the best results for you. Try to be patient if you are asked the same questions more than once.

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Review Date: 1/30/2018

Reviewed By: John E. Meilahn, MD, Bariatric Surgery, Chestnut Hill Surgical Associates, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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