Gastric bypass bariatric surgery is an operation developed to rearrange the human anatomy in order to assist the morbidly obese patient to lose weight in order to live a healthier and more productive life. The operation in itself is a very minute part of the process of a bariatric procedure. Gastric bypass surgery is a lifestyle changing operation. The patient needs to be appropriately prepared for this change in lifestyle. The morbidly obese patient is required to prepare for months before the operation. It may take anywhere from six to eight months for a patient to be prepared for the actual operation. Preparation will require the services of several medical and healthcare specialists including nutritionist, Internists, cardiologists and psychologists. Proper preparation can afford the patient a much more favorable outcome from the surgery.
At the very beginning, it is up to the patient to initiate the start of the process of preparation for gastric bypass surgery. It is of the upmost importance that the patient understands that this procedure is not a quick fix, no effort cure for obesity. They also need to understand that it requires a specialist in bariatric surgery to successfully guide the patient through the process. Choosing a surgeon is the first step. Most surgeons can technically perform the operation; however it requires a specialist who has the training and knowledge of the preparation requirements. Patients need to find a bariatric surgeon who is part of a Bariatric Surgery Center Network (BSCN) Accreditation Program recognized by the American College of Surgeons.
The first step in the preparation will be the initial visit to the surgeon. During this visit the patient will be evaluated to determine if they are a good quality candidate for the surgery. Good candidates are patients between the ages of 16 and 65 who are in relatively good health with a high body mass index. Patients who are at high risk of obesity related diseases or life threatening conditions are also good candidates. Patients must comprehend the risks involved and potential complications that may arise. Also, during the first visit candidates are advised of the process that has to be undertaken before the surgery can be performed. Lastly, the patient must ask questions of the surgeon to assure the surgeon is qualified to perform the procedure. Questions such as: how many procedures have they performed, what and how many complications have they had and where the procedure be performed.
Dietary consultation with a registered nutritionist is an important step in the preparation for gastric bypass surgery. Most insurance companies require six months of nutritional counseling before surgery is approved. The nutritional consultation will include detailed evaluation and examination of the patient’s present nutritional status and groundwork for the lifestyle change after the surgery. The gastric bypass operation not only changes the anatomy of the morbidly obese, it also affects the nutritional intake. Gastric bypass patients will experience a loss of crucial vitamins and minerals, such as such as Vitamin B12 and C and calcium. Nutritional counseling is a twofold educational experience. The first is preparing the patient for the surgery from a nutritional standpoint to assure the patient is nutritionally sound at the time of surgery. The second is educating the patient about lifestyle changes that will obtain a more optimal transition after the surgery.
Morbidly obese candidates for a gastric bypass bariatric surgery are required to undergo a psychological assessment, evaluation and counseling in preparation for the surgery. This assessment and evaluation will determine if the patient is psychologically able to adjust to the life style changes associated with gastric bypass surgery. Patients are assessed on behavioral, activity, substance abuse, health related risk taking behavior, cognitive and emotional and psychopathology behavior. Any area of concerned may necessitate therapy or intervention to treat prior to the surgery. The psychological evaluation assures that the patient has a thorough understanding and expectations of the life style change forthcoming. Counseling in dealing with stressors, utilizing social support and motivation will improve the outcome of the surgery.
Comprehensive medical evaluations will be required in preparation for gastric bypass bariatric surgery. This is due to certain medical conditions that are highly associated with morbid obesity. Patients will be evaluated by a variety of medical specialties including cardiology, pulmonary and endocrinology. Others may be required in specific patient circumstances. A thorough cardiac workup to evaluate the health of the heart is of most importanance to optimize a positive outcome from the surgery. Evaluation of the patient’s lung function, especially smokers, is critical to determine if they are healthy enough to withstand the stress of surgery. Type II Diabetes and hyperlipidemia are highly associated with morbid obesity and will require evaluation and treatment. All of these evaluations should be performed early in the process, due to the possible need of therapy and treatment to correct any abnormalities.
Other specialized evaluations may be considered with specific findings by the physician upon the initial evaluation. These may include gastrointestinal, musculoskeletal, genitourinary, gynecological, and onocologic evaluations. Certain patients may be required to undergo these special evaluations and/or treatments in preparation for gastric bypass bariatric surgery.
After a patient has completed all the preparation, they are ready for the gastric bypass bariatric operation. Although this preparation may be seen lengthy, it is has been found to be paramount in producing the optimal outcome for the patient. Optimal outcome of gastric bypass bariatric surgery will afford the patient a better lifestyle that is healthier from a medical standpoint as well as psychosocial and emotional.
