What is Required Before Surgery
For healthy patients with no outstanding medical problems, only the baseline tests are required – mainly blood tests (including a three-hour glucose tolerance test to look for diabetes). All insurance plans require psychiatric evaluation and nutritional assessment. Additional pre-operative testing – Chest X-Ray, EKG, Ultrasound and last minute blood testing – will be performed on your pre-operative day in the clinic. Note that patients who are undergoing the non-surgical Orbera gastric balloon procedure have significantly less testing than those who are undergoing surgery.
Other patients with known medical problems or symptoms of medical conditions may be required to see various specialists for testing or treatment in order to be in the best condition possible for surgery. This may include evaluation by a Cardiologist, Pulmonologist or other specialist, or possibly a sleep study for diagnosis of sleep apnea. This testing is critical for those who need it, as the risk of having one or more complications escalates if existing medical problems are not appropriately addressed before surgery. I always tell patients that they must get their testing and any pre-operative treatments completed on time, or they will not have surgery on time. I will never perform surgery on a patient who hasn’t had the necessary evaluation and treatment(s) to minimize their risk of complications.
Everyone who wants to have surgery must undergo a psychiatric evaluation. This is extremely important whether you currently see a psychiatrist, therapist, etc., or not. This evaluation generally takes about an hour and can only be performed by a Psychiatrist or Licensed Clinical Psychologist. The purpose of the evaluation is to ensure that any existing diagnoses (depression, etc.) are well managed prior to undergoing surgery, and to ensure that all patients have a solid understanding of the surgery itself and reasonable expectations for after surgery. It can also be extremely helpful in identifying potential stressors for each individual patient that may trigger stress snacking after surgery. I can provide recommendations for some very good psychologists in the San Diego area, as well as in many outlying areas.
Note that in the absence of known psychiatric disease, patients who are getting the Orbera gastric balloon procedure do NOT need psychiatric or nutritional evaluations.