PRE-OPERATIVE OPTIMISATION & ASSESSMENT

Sustained weight loss can prove difficult for many. Surgery is a choice for many how have tried many other methods first. Here at SWM, we only offer surgery as per national guidelines that must be followed both in the NHS and private practice. These are set by NICE: national institute for care excellence. This states that to qualify for bariatric surgery patients must have a highest weight that gives them a BMI (body mass index of >35), unless they have type 2 diabetes, in which it can be from a BMI of 30 and above; this BMI can be 2.5 less for those of eastern (Asian) origin due to the increased risks of excess weight in this cohort.

For safe bariatric surgery, and the best outcomes the procedures must be delivered within the framework of a multidisciplinary team (MDT). Therefore patients MUST be assessed by at least a surgeon, bariatric dietician and psychologist prior to surgery and their anaesthetic risk be assessed by a bariatric trained anaesthetist.

At SWM, we take these criteria very seriously and adhering to them, allows not just for best practice, but also for better long-term results. This is why there are a minimum of these 3 consultations prior to surgery. A full set of blood tests and sometimes a heart tracing may be carried out as well. If any of these yield a diagnosis not previously known about, e.g. type 2 diabetes, high blood pressure, heart problems, gastrointestinal issues, then further diagnostics and referral to the appropriate specialist in our team may be needed.

Surgical assessment

This involves meeting your consultant bariatric surgeon in person or virtually. Your weight issues, medical history, surgical history, medications, allergies and other details are discussed. The operations that you may be interested in are discussed. The benefits and risks are explained. The process of having the procedure is discussed. This is often takes up to 1 hour and is very detailed so that your surgeon starts to get to know you and so that you get to know more about him and his team.

Dietetic assessment

This is a detailed assessment is carried out by a specialist dietician trained to work with patients who have had long term weight issues and go onto consider surgery. It is important to take the time to be open, honest and frank about your diet history and problems so that we can help you in the best way. Your dietician will also look into your weight loss expectations and help to manage these realistically. Your dietician will also explain the pre- and post operative diet.

Psychological assessment

This holistic and thorough appointment is carried out by a trained clinical psychologist, with an interest and background in weight gain issues and the potential causes of this excess weight. This appointment will also look to assess you coping strategies in the post surgical phase and explore your mental history if you have one.