| Dr. Carlos Ferrari is a member of the American Society for Metabolic and Bariatric Surgery. Here the Doctor has answered some of the common questions Bizymoms visitors have about Bariatric Surgery.
Q. What are the routine tests before bariatric surgery?
A. The testing required before bariatric surgery is going to depend on two major factors. The first is the tests requested by me after the initial consultation. Typical tests ordered by me will be comprehensive blood work, echocardiograms, cardiac clearance for surgery, gallbladder ultrasounds and sleep studies. The second factor determining which tests need to be done before surgery will depend on the patients insurance plan. These tests typically include nutritional evaluations, psychological evaluations and medically supervised diets. These are just the typical tests and will vary from patient to patinet depending on my consultation with the patient and the insurance plan.
Q. What is Gastric Bypass surgery?
A. The Roux-en-Y Gastric Bypass is the most commonly performed weight loss surgery in the United States. It is a procedure that has been closely studied and yields predictable results. Surgical results are excellent and the mortality rate of the procedure is extremely low at a national rate of less than .2% when performed at a Center of Excellence. The gastric bypass is performed laparoscopically and involves the reduction of the size of the stomach to a small pouch which is connected directly to the small bowel in a way that bypasses the stomach and portion of the intestines. The net result of the surgery is not only a decrease in the amount of food the patient eats but also adds a strong metabolic change in the body due to the bypassing of the stomach and portion of the intestines. This metabolic change enhances weight loss for approximately two years. It is important for patients to understand that with the gastric bypass, and with any bariatric procedure, there must be a lifestyle change that includes physical activity and healthy dietary habits for the long term success of the surgery.
Q. Who is a good candidate for these types of surgeries?
A. Typically, patients who have a body mass index of 40 or more are candidates for bariatric surgery. Patients who have a body mass index of 35 or higher may qualify if they suffer with two comorbidities. Comorbidities include diabetes, hypertension, sleep apnea, hypercholesterolemia, and hyperlipidemia. These qualifications are required by insurance companies. There is a movement to decrease the body mass index requirements to 30 since there are indications that patients who are lighter in weight but who suffer with comorbidities show more dramatic results if operated on earlier. After a thorough evaluation , if I determine that the benefits of bariatric surgery outweigh the risks, the patient is considered a good candidate for this surgery.
Q. What is the cost involved in the different types of procedures?
A. The total cost to the patient will depend on the surgical procedure they choose and if they use insurance. If the patient has insurance coverage for bariatric surgery, the patient will be responsible for their deductible and any co-insurance or percentage of responsibility outlined in their plan. For self pay patients there is a discounted global package price. This is one price for all the parties involved with the surgery. The patient is given a clear picture of what the total cost of the surgery will be. This price will include surgeon fees, surgical assistant fees, anesthesia fees, hospital stay and some follow up care.
Q. What is the Bariatric Surgery recovery process?
A. Normally, we ask all patients to wait two weeks until returning to normal activity, work and exercise. Immediately following surgery, patients will follow a liquid diet for two weeks. After two weeks, patients will gradually begin to introduce soft solid foods into their diet. By the sixth week most patients are able to move on to include regular foods into their diet. Routine follow ups and long term nutritional care is also required by me.
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