Dr. Myers, What Standards Help to Make Bariatric Surgery as Safe and Effective as possible?

We have designed standards into our bariatric surgery program that generates exceptionally low complication rates and outcomes that are about 20% better than reported averages. Some of these standards are listed below:

Since the risk to the patient increases with a BMI over 55, patients must be at a BMI of 55 or less prior to operation. If a patient’s weight exceeds this they should be treated medically to assist them in losing weight to reach a BMI of 55.

A Very Low Carbohydrate Diet is started several days before operation in non-diabetic patients and 2 weeks prior to operation is diabetics to decrease the size of the liver making it easier and safer to perform the bariatric operation.

We prevent blood clots from forming by using Lovenox, (a blood thinner), while in the hospital and for 6 days postop. We also require early walking the night of the operation and use compression garments to keep circulation flowing even while patients are resting in bed. For patients of higher risk they will be asked to have a special temporary filter placed in the vein returning blood from the lower half of the body back to the heart to prevent blood clots from reaching the heart and lungs.

Patients with a diagnosis of obstructive sleep apnea must be compliant with their CPAP for at least 3 weeks before their operation to alow their heart to become stronger and the CPAP level is adjusted where necessary to no more than 10 cms of H2O after surgery to prevent excess air in the gastrointestinal tract.

Blood pressure medicines called ACE inhibitors and ARBS are discontinued or decreased several days prior to surgery to make sure the patient’s blood pressure does not become too low during surgery.

Patients must stop smoking at least 6 weeks prior to operation. This decreases their risk of ulcer formation and decreases the risk of blood clots as well.

Patients must agree to participate in all of the components of Fresh Start Bariatrics and pay for the program prior to surgery. This helps to motivate them to complete the exercise and dietary portions of the program.

The patients proceed to insurance approval and on to surgery only after the dieticians, psychologist and medical personnel all agree that they are ready to proceed.

All of htese standards help to decrease risks and inprove longterm results.