Patients who come for treatment of obesity will not be taken up for surgery straight away. The following steps are taken prior to advising surgery
First visit:
Initial Assessment shall include:
- Presenting complaints/history
- Height
- Weight
- BMI (Body mass Index)
- Clinical Examination: heart rate, blood pressure, respiratory rate, saturation on room air
- Systemic examination: of the cardiovascular system, respiratory system, neurological system and abdominal examination
- Previous weight loss methods
- Co-morbid conditions: Diabetes Mellitus, Coronary artery disease, Hypothyroidism, Dyslipidemia, Osteoarthritis, Psychiatric illness, Obstructive sleep apnea, cancer, chronic obstructive pulmonary disease, Hypertension etc
- Family counselling
Initial Consultation is done with:
- Anesthetist
- Endocrinologist
- Pulmonologist
- Cardiologist
- Dietician
- Physiotherapist
- Intensivist only in high risk cases
Investigations:
3 weeks pre-operative:
-
Hematology
- Complete blood count
- Coagulation profile
- Fasting and post prandial blood sugar estimation
- HbA1C (Glycosylated haemoglobin)
- Fasting C- Peptide levels ( In diabetics)
- Urea
- Creatinine
- LFT
- Thyroid profile
- Fasting lipid profile
- HIV, HCV, HbsAg
- Renal profile
- Serum vitamin B12
- PTH
-
Radiology
- Chest X Ray
- Ultrasound abdomen and pelvis to r/o gallstones and polycystic ovarian disease
-
Cardiac evaluation
- Resting ECG
- ECHO
-
Pulmonology
- PFT (pulmonary function tests)
- Sleep study (as decided by anesthetist/ pulmonologist)
-
Gastro enterology
- OGD to rule out tumor/ large hiatal hernia and treat H. Pylori if positive