What to Expect During Bariatric Surgery at UPMC in South Central Pa.

We work closely with you through the entire surgical process, providing expert guidance and support from your first consultation through surgery and beyond.

Getting Started

All new patients are required to attend an information session. At this session you will have the opportunity to learn about the various options available for weight loss, as well as meet the staff and schedule a consultation with our bariatrician and dietitian. You will also be given an information packet to fill out and bring to the information session. One week prior to your provider appointment a insurance coordinator will call you to discuss insurance requirements.

Step 1: Consultations Prior To Bariatric Surgery

• Provider. This is your first consultation/visit at UPMC Pinnacle. You will meet with one of our bariatric providers. They will review your medical history and discuss weight-loss surgery and weight management options. (A bariatric provider is a physician who specializes in the treatment of obesity and obesity related disorders.) Based on your medical history, our providers will assist you in selecting the safest and most successful weight-loss option. Our providers may request that you obtain up-to-date blood work. After this visit you will start pre-surgical insurance requirements and clearances as required by our providers. The bariatric provider will meet with you regularly after surgery to monitor your progress with weight loss and nutrition.
• Dietitian. Every patient is required to meet with the dietitian. A 3-6 month diet may be required by your insurance. The registered dietitian will help prepare you for surgery.
• Psychologist. We believe mental preparedness for complete lifestyle change is important. Each patient considering bariatric surgery will be evaluated by a mental health professional to evaluate readiness for surgery.
• Bariatric surgeon. You will discuss all weight-loss surgery options and risks with your bariatric surgeon of choice. Your surgeon will review your medical and surgical history and assist you in choosing the best surgical option for you.

Step 2: Clearances Required Before Bariatric Surgery

You may be required to see a specialist(s) if you have an existing condition(s) for additional testing/clearance prior to surgery. The clearances should be completed during your pre-op diet period.

Step 3: Insurance Approval Process

• Pre-op diet requirement. These appointments are with the bariatric provider and/or the registered dietitian to review current dietary habits and lifestyle, meal planning, etc. These must be completed as per insurance requirements. Note: Most insurances require 3 to 6 months (consecutive) monitored and documented diet prior to surgery.
• Clearances. Required insurance and/or specialty clearances must be received.
• Final Requirements. Any additional patient requirements must be completed (e.g. psychological clearance, etc.)
• Insurance Submission. All requirements /clearances are submitted to insurance.
• Approval. Insurance approval may take 2-6 weeks depending on the insurance provider.
• Pay/co-insurance. You will be required to pay any co-insurance or other outstanding balances at this appointment in order to schedule your surgery date.

Step 4: Pre-Op Education

• Pre-operative nutrition and education appointment. The pre-operative nutrition and education appointment is done in a group setting with our registered dietitian (RD) and registered nurse (RN) to review dietary requirements and progression for post-surgery. Note: At this appointment, you may also be instructed to follow a special pre-operative, high protein, liquid diet for approximately 2 wks prior to surgery, as indicated by your surgeon.
• Pre-operative exam appointment. At this appointment you meet with our bariatric provider to review medications and pre-operative test results. Some medications may need to be adjusted or stopped prior to surgery to reduce the risk of complications during surgery and post-operatively.
• Pre-operative class and hospital tour with a bariatric coordinator. All patients are required to attend a pre-operative class at the hospital, taught by an RN, to help prepare for surgery day. Topics include what to expect while at the hospital, prior to and immediately following surgery, as well as reminders for a successful recovery. Our RN also provides a private tour of the hospital at the end of class. Patients are welcome to bring their primary care giver to this class.

Step 5: Preparation for Bariatric Surgery

You will need to undergo the following tests prior to your surgery:

• EGD (Upper endoscopy)
• Medical history
• Physical
• Blood tests
• Gallbladder Ultrasound (for gastric bypass patients)
• EKG (Electrocardiogram)

Step 6: Follow-Up Care

Follow-up care is very important to ensure healthy progress and success following surgery. You can expect to schedule the below required follow-up appointments, after surgery:

• 7-10 days postoperative appointment with your surgeon
• 3 month appointment with your medical provider and Registered Dietitian at the WLC
• 6 month appointment with your medical provider and Registered Dietitian at the WLC
• 9 month appointment with your medical provider and Registered Dietitian at the WLC
• Annually meet with your medical provider and Registered Dietitian at the WLC
• Exercise appointment scheduled with our Exercise Physiologist once cleared to begin exercising by your surgeon or medical provider

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