Evaluation for Bariatric Surgery

Patients who come for treatment of obesity will not be taken up for surgery straight away. The following steps are taken prior to advising surgery

First visit:

Initial Assessment shall include:

  • Presenting complaints/history
  • Height
  • Weight
  • BMI (Body mass Index)
  • Clinical Examination: heart rate, blood pressure, respiratory rate, saturation on room air
  • Systemic examination: of the cardiovascular system, respiratory system, neurological system and abdominal examination
  • Previous weight loss methods
  • Co-morbid conditions: Diabetes Mellitus, Coronary artery disease, Hypothyroidism, Dyslipidemia, Osteoarthritis, Psychiatric illness, Obstructive sleep apnea, cancer, chronic obstructive pulmonary disease, Hypertension etc
  • Family counselling

Initial Consultation is done with:

  • Anesthetist
  • Endocrinologist
  • Pulmonologist
  • Cardiologist
  • Dietician
  • Physiotherapist
  • Intensivist only in high risk cases

Investigations:

3 weeks pre-operative:

  • Hematology
    • Complete blood count
    • Coagulation profile
    • Fasting and post prandial blood sugar estimation
    • HbA1C (Glycosylated haemoglobin)
    • Fasting C- Peptide levels ( In diabetics)
    • Urea
    • Creatinine
    • LFT
    • Thyroid profile
    • Fasting lipid profile
    • HIV, HCV, HbsAg
    • Renal profile
    • Serum vitamin B12
    • PTH
  • Radiology
    • Chest X Ray
    • Ultrasound abdomen and pelvis to r/o gallstones and polycystic ovarian disease
  • Cardiac evaluation
    • Resting ECG
    • ECHO
  • Pulmonology
    • PFT (pulmonary function tests)
    • Sleep study (as decided by anesthetist/ pulmonologist)
  • Gastro enterology
    • OGD to rule out tumor/ large hiatal hernia and treat H. Pylori if positive

 

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