MULTIDISCIPLINARY PREOPERATIVE ASSESSMENT MUST BE CARRIED OUT BEFORE ANY BARIATRIC SURGERY (SLEEVE GASTRECTOMY, GASTRIC BYPASS...)
It is based on justified and imperative recommendations from the French National Authority for Health (HAS) and includes the following elements (in the absence of a complete assessment, the intervention cannot be performed due to a refusal by the CPAM).
The SURGEON during the first consultation specifies the characteristics of obesity (weight, height, age, profession, pregnancies, inheritance, comorbidities such as diabetes, high blood pressure, sleep apnea) and starts the BALANCE SHEET.
Preoperative exams and consultations N ° 1, 2 and 3 must be carried out quickly, in particular consultation with the nutritionist, the date of which conditions that of the intervention 6 months later (imperative deadline for obtaining authorization from the Health Insurance Fund (CPAM).
1. The blood test and vitamins D, B1, B6, B12 is essential for all specialists.
2. The nutritionist writes a history of obesity, its age, its modalities, behavior and eating habits. It should be seen 2 or 3 times during the review period.
3. The pulmonologist searches for a frequent beginner syndrome (SAS), especially in patients who complain of snoring, restless sleep and drowsiness.
AFTER this first part of the BALANCE SHEET the SURGEON will have to be reviewed. Remember to make a consultation appointment!
4. The endocrinologist, based on the blood test, checks that obesity has no medical cause which may be responsible for the excess weight (thyroid disease) to be treated, if necessary.
5. The gastroenterologist will perform a gastric endoscopy, most often under anesthetic sedation, checking the integrity of the stomach and the absence of a germ (Helicobacter pylori) to be treated before any intervention.
6. The psychiatrist is looking for a psychiatric history or eating disorder.
7. The cardiologist searches for high blood pressure and practices a cardiac ultrasound for surgery to study how the heart works before surgery.
8. Second consultation appointment with the nutritionist.
ALL THESE ELEMENTS allow the mandatory Multidisciplinary Concertation Meeting (RCP), bringing together all these specialists, to give a written report on each file, which report will be sent for acceptance to the Social Security center of the patient.