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❱ This surgery is indicated for those patients with type 2 diabetes mellitus, who despite medical treatment do not achieve an adequate control of the disease.

❱ If, in addition, the patient who is a candidate for metabolic surgery presents other alterations such as high cholesterol, triglyceride or blood pressure values, these will be significantly improved with surgery.

❱ Improves and/or corrects fatty liver disease
❱ Improves sugar disorders.
❱ Decreases the risk of some types of cancer.
❱ Improves musculoskeletal disorders.
❱ Improves hypogonadism.

Laboratory studies

❱ Hemogram
❱ Liver function and alteration tests (TGO, TGP, albumin, total proteins, alkaline phosphatase, GGT, direct and indirect bilirubin).
❱ Renal function tests (BUN, urea, creatinine)
❱ Coagulation tests (PT, PTT, INR)
❱ Complete lipid profile (total cholesterol, triglycerides, HDL, LDL)
❱ Fasting glucose, HbA1c, insulin, C-peptide, HOMA IR.
❱ Vitamin profile (vitamin b1, vitamin b12, vitamin D, vitamin A).
❱ Calcium, phosphorus, magnesium, sodium, potassium, chlorine.
❱ Iron, ferritin, transferrin, folic acid.
❱ Thyroid function tests (TSH, free and total T4 and T3).
❱ Parathyroid function tests (PTH).
❱ Viral tests (HIV, HbsAg, Hepatitis C, VDRL)* These tests should be requested with the patient’s consent, explaining why they are requested.
❱ General urine test
❱ Women of childbearing age should request a BhCg to rule out pregnancy.

Imaging and interventional studies

❱ Chest X-ray PA
❱ Upper abdominal sonography (*INDISPENSABLE in patients undergoing bypass procedures).
❱ Upper endoscopy with biopsy (d/c helicobacter pylori infection and chronic inflammatory and malignant pathologies).
❱ Gastroduodenal Esophageal series contrasted.
❱ Additional studies: manometry, phmetry, computed tomography, magnetic resonance imaging.

(BE CAREFUL with the realization of studies and the weight of the patient, this is necessary to take into account when requesting the studies).

Additional studies

❱ Electrocardiogram of 12 derivations.
❱ Echocardiogram in patients with special conditions.
❱ Spirometry in smoking patients or with evidence of obstructive pathology.
❱ Polysomnography in patients with evidence of OSA.

Assessments 

❱ Cardiovascular evaluation with risk score and measures recommended by the specialist physician before and after the surgical procedure.

❱ Pneumology evaluation (all patients should be evaluated by pneumology since obesity produces a respiratory restrictive pattern which directly affects the respiratory condition of the individual increasing the risk of anesthetic complications during the procedure.

❱ Mental health evaluation: rule out major disorders and eating disorders, take into account the assessment of the quality of life of the individual.

❱ Psychiatric evaluation: in case medication is required to control eating disorders such as binge eating disorder or night eating syndrome among others.

❱ Nutritional evaluation: evaluation and prescription of diets, to help at the beginning of the treatment, including hypocaloric diet 2 weeks before the procedure to decrease the hepatic volume.

❱ Anesthesia evaluation: should consist of an evaluation after completing the pre-surgical preparation.

❱ 1 day before the surgery with the bariatric surgeon to draw the guidelines one day before the surgery.

Note: The patient must arrive at the destination at least 7 days before the procedure date.

Complications in bariatric surgery can present themselves with different degrees of complexity, which is why it is important to have an integral management with a multidisciplinary team. The most common complications are:

❱ Bleeding; it may occur early or late. This can be minimal and may require conservative management, with the use of medication, or it can reach the point where the patient presents shock, requiring immediate surgical intervention.

❱ Leaks; they can occur in different surgical procedures and their management will depend on the hemodynamic status of the patient; from endoscopic or surgical management.

❱ Stenosis; it is a late complication that may cause food intolerance in the patient.

This type of surgery is performed routinely and with a very low complication rate. Interventions are performed through small incisions in the abdomen, minimizing scarring and facilitating the patient’s recovery.

Generally, after 24-48 hours in which an adequate oral tolerance has been achieved and the patient is in a good general condition, the patient can go home to continue his complete recovery.

❱ All laboratory tests
❱ All studies
❱ All medical evaluations by the multidisciplinary team.
❱ Private nurse during your stay at the medical center
❱ Surgical equipment
❱ Physician fees
❱ In-patient medical facility pregnancy.

❱ Any lab, EKG, x-rays, biopsy, MRI, etc.)dical facility pregnancy.

❱ From US $9,500 to US $20,000.