• You obtain relevant medical records from the past five years
• Our office sends a letter of medical necessity to your insurance company requesting approval for the procedure
• Medical evaluation as needed to minimize risks of surgery
• Nutritional consultation with a dietician       
• Psychological evaluation with a psychologist or psychiatrist

Once we have obtained insurance approval and completed the medical, nutritional and psychological evaluations, our office will schedule a surgery date with you. We will see you in the office at least one more time prior to surgery for a pre-operative visit. At that visit, we will review your work-up and make sure that you have a good understanding of the expected course after surgery. It will be an opportunity for you to ask further questions and you are encouraged to bring family members or friends to this visit, particularly if they have specific concerns or questions 

At the pre-operative meeting, you will receive individualized instruction regarding the time of surgery, when to stop talking in food and liquids, and what to do about medications the day of surgery. In general, patients are instructed to take nothing by mouth after midnight the night before surgery. Regarding medications, in general patients are asked to stop taking over-the-counter medications and herbal supplements one week prior to surgery. Patients taking insulin and oral diabetes medications should expect individualized instruction regarding these medicines. Patients who use Continuous Positive Airway Pressure (CPAP) or Bi-level Positive Airway Pressure (BiPAP) will be asked to bring their machines with them for use immediately after the operation.

After the pre-operative meeting with your surgeon, there is not much for you to do. We do not place our patients on a rigorous pre-operative diet, nor do we give pre-operative bowel preparations. However, we do encourage our patients to eat in moderation for the two weeks prior to surgery, emphasizing high protein, low fat meals and minimizing excess carbohydrates. Overeating and binge eating in the weeks prior to surgery can lead to acute fatty infiltration of the liver and possibly increases the likelihood of conversion from a laparoscopic to open surgery.

information on In the Hospital

information on After Surgery