Once you have had your 3 initial consultations (bariatric surgeon, dietician and psychologist), if you have decided to have your surgery with us, then a full set of blood tests will be taken and the results assessed. These along with your assessments usually lead to clearance for surgery. However occasionally something is picked up that need further tests or opinions. Here are some examples:
Type 2 diabetes, occasionally if very significant may need management by a specialist diabetologist and their team prior to surgery as well controlled diabetes means safer surgery.
Obstructive sleep apnoea. This is a common condition that causes loud snoring during sleep, which leads to less oxygen being taken in and so poor quality sleep, tiredness during the day and excess fluid in your system that can cause swollen legs and ankles. This needs diagnosis with a sleep test and treatment with a special mask to sleep with that provides pressurized oxygen at night (CPAP, continuous, positive airways pressure).
High blood pressure. This can be treated with lifestyle changes and medication. Your blood pressure should be well controlled prior to surgery , to reduce risks of bleeding and stroke.
Low vitamin levels. Low vitamin D is very common and we would supplement any patient with any low micronutrient levels prior to surgery and after surgery.
Anaemia: this means having a low haemoglobin (your blood count). If this is the case usually gastroscopy (upper GI endoscopy) and a colonoscopy may need to be carried out to make sure that the low blood count is not because of occult blood loss from the gastrointestinal tract.
Significant indigestion or acid reflux (heartburn): a long history of these would necessitate a gastroscopy prior to surgery. To help advise you on the best procedure for you and to rule out stomach ulcers.
If you have had previous upper gastrointestinal surgery or even bariatric surgery, you will need a CT scan and or a barium swallow and or gastroscopy depending on the type of previous surgery you have had.
CT scan: A computerised tomography (CT) scan uses X-rays and a computer to create detailed images of the inside of the body.
Barium swallow/meal: a special type of X-ray test that helps your doctor take a close look at the back of your mouth and throat, known as the pharynx, and the tube that extends from the back of the tongue down to the stomach, known as the oesophagus (gullet) and stomach
Gastroscopy (upper GI endoscopy): is a procedure where a thin, flexible tube called an endoscope is used to look inside the oesophagus (gullet), stomach and first part of the small intestine (duodenum), carried out under sedation.
Colonoscopy: is a test to check inside your bowels. This test can help find what's causing your bowel symptoms. A long, thin, flexible tube with a small camera inside it is passed into your bottom, under sedation. You'll be given a laxative the day before your colonoscopy, so your bowels are empty for the test.
Sleep test: also known as polysomnography, also called a sleep study, is a test used to diagnose sleep disorders. Polysomnography records your brain waves, the oxygen level in your blood, heart rate and breathing. This test is used to diagnose sleep apnoea.
These tests will only be requested if clinically indicated and to make your surgery safer of to get you better long term results by aiding your decisions prior to surgery.
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St Mary’s Hospital
South Wharf Road
London W2 1B
1 Wellbeck Street
21 Wigmore Street
23 Lombard Court
King Edward 7th Hospital,
5-10 Beaumont Street,
London W1G 6AA