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PREOPERATIVE ASSESSMENT

A MULTIDISCIPLINARY PREOPERATIVE ASSESSMENT must be carried out before any bariatric surgery (Sleeve Gastrectomy, Gastric Bypass in Y, Gastric Band).

The purpose of these pre-op consultations is primarily to help obtain and consolidate permanent weight loss postoperatively.

It is based on justified and imperative recommendations from the French National Authority for Health (HAS) and includes the following elements (in the absence of a complete assessment, the procedure cannot be performed due to a refusal by Social Security).

During the first consultation the SURGEON  identifies the characteristics of obesity (weight, height, age, profession, pregnancies, hereditary factors, comorbidities such as diabetes, high blood pressure, sleep apnea) and starts the assessment.

Preoperative exams and consultations N ° 1, 2 and 3 must be scheduled quickly, specifically the appointment with the nutritionist, the date of which will condition that of the procedure 6 months later (mandatory wait period for obtaining the authorization from the national Health Insurance organization (CPAM).
  1. A full blood workup and vitamin D, B1, B6, B12 dosages are essential for all specialists.
  2. The nutritionist writes up a history of your obesity, its start, its modalities, behavior and your dietary habits. She should be seen 2 or 3 times during the review period.
  3. The pulmonologist searches for signs of sleep apnea, especially in patients complaining of snoring, restless sleep and drowsiness.
AFTER this first part of your exams the SURGEON will have to be seen again. Remember to make an appointment.
  1. The endocrinologist, based on blood test results, checks that there is no medical cause which may be responsible for the excess weight (thyroid disease) to be treated, if necessary.
  2. The gastroenterologist will perform a gastric endoscopy, most often under anesthetic sedation, to check the integrity of the stomach and look for the presence of a common germ (Helicobacter pylori) which must be treated before any procedure.
  3. The psychiatrist is looking at psychiatric history or for any signs of an eating disorder.
  4. The cardiologist searches for high blood pressure and carries out a cardiac ultrasound to study how the heart works before surgery.
  5. Second appointment with the nutritionist.
ALL THESE ELEMENTS allow the mandatory Multidisciplinary Concertation Meeting (RCP), bringing together all these specialists, to give a written report on each case, which will be sent to the patient's Social Security center for approval.

 

♦To make an appointment with Dr. Bruto Randone, Digestive and Bariatric Surgeon, at the Clinique Internationale du Parc Monceau, 21 Rue de Chazelles, 75017 Paris, France, or at the Clinique Bizet, 23 Rue Georges Bizet, 75116 Paris, France, click on Contact