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Sep 02, 2014

Pre-Operative Care and Evaluation

Veterans identified by their primary care medical providers as potential bariatric surgery candidates will be screened by the bariatric surgeon and other bariatric surgery team members at a VHA or outside facility, per the referral process detailed in the VHA Handbook on Bariatric Surgery. In general, selected patients meet with the surgeon and other bariatric staff (dietitian, psychologist, others), usually more than once, to prepare for surgery. In some VHA facilities, this meeting can be arranged via video teleconferencing. The following table (11-1) describes the role of various team members when preparing a patient for bariatric surgery.

Table 11-1: Roles of Bariatric Surgery Team Members Team Member

Topics Covered

Primary Care Provider

  • Perform initial medical evaluation and determine if patient meets medical criteria for surgery.

• Stabilize chronic underlying conditions.

• Coordinate with pharmacist (see below) to safely change medications to instant release formulations prior to surgery.

• Arrange for patient consultations with other team members.

Surgeon

  • Identify needed preoperative requirements to improve surgical outcomes.
  • Determine if preoperative weight loss is indicated (surgery in patients with very high BMI can be technically more difficult and carry a higher risk of complications).

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