Bariatric Surgery Program

Step 1

Initial contact with the Bariatric Surgery Program at University Hospitals Case Medical Center

Call:  (216) 844-5961/ option 1.  OR 1(866) UH4CARE (844-2273) to make your initial consultation appointment with one of the surgeons and reserve your seat for one of the pre-op support group meetings.

For forms and documents to be filled out for new patient appointments, please follow this link.

Step 2

First Visit:

During the first visit, members of the Bariatric Surgery Program team assess the patient's current knowledge about bariatric surgery. The candidate is also informed of the comprehensive program elements offered to see patients through the surgery and beyond. In fact, extensive, ongoing monitoring and support services are available to patients for the rest of their lives.

The first visit also requires that individuals relate their health and weight histories in detail so that the team can assess the number and types of attempts that have been made to lose weight, as well as any physical problems that are caused by their weight (i.e., diabetes, high blood pressure, sleep apnea, etc.) and weight management efforts.

Typically, patients are seen at least three times prior to surgery, and these visits are usually one month apart. At each visit, patients spend time with their surgeon, either Thomas A. Stellato, M.D., Peter Hallowell, M.D., or Dr. John Jasper, MD, along with other members of the Bariatric Surgery Program team. These visits help to prepare patients for the surgery and the lifestyle changes that they face, as well as the significant quality of life and health improvements that result from the surgery.

During this period, individuals considering the surgery or enrolled in the process to have the surgery are required to participate in an ongoing series of open support groups that includes both pre- and post-op patients. These meetings enable individuals to raise any questions or concerns that they may have about the surgery, as well as learn more about what is involved in the process from Dr. Stellato, Dr. Hallowell, Dr. Jasper and other Program members, along with post-op patients who have already been through the Program.

Second and Third visits are scheduled after insurance approval is obtained.

Step 3

Second Visit:

This visit entails informing the person about the details involved in preparation of the surgical procedure. This includes all of the components of a typical hospital stay, testing that is required while they're in the hospital, items needed for home after surgery, expectations of recuperation and the follow-up visits afterwards. Also included in this session is a detailed discussion with the Registered Dietician about the post-operative diet and dietary issues.

Step 4

Third Visit:

This visit is usually scheduled two weeks prior to the surgery date. At that time, the patient's pre-admission testing is performed. This testing includes required labwork, such as EKG, chest x-ray, and blood tests. This visit also includes an assessment by someone from the anesthesia department. After pre-admission testing is complete the pre-op patient will have a final visit with their surgeon. At this time the surgery consent form is reviewed in detail and final items needed for surgery are completed.

Step 5

The hospital stay typically lasts two-three days for patients undergoing a Roux en 4 gastric bypass.  Patients undergoing the Lap Band procedure will usually be in the hospital overnight.

Step 6

The Roux-en-Y gastric bypass surgery is performed.

Learn more about the Roux-en-Y gastric bypass operation.

Following surgery, patients are taken into the Post-op recovery area. Once the patient is awake, they are transferred to their regular hospital room, located on Lerner Tower 9. During this time, nurses assist the patients in getting out of bed and ambulating starting the night of surgery to expedite their recovery and prevent complications.

Step 7

Day two of the hospital stay includes giving the patient an esophagram, or swallow study, to ensure that there are no leaks within the digestive tract, specifically in the new stomach pouch or newly attached intestine. Additionally, the procedure ensures that the anastomosis, or the connection between the stomach pouch and the small intestine, is open, and liquids can flow readily through it into the small intestine, where digestion begins.

Patients stand in front of the X-ray equipment and are given a small amount of contrast to swallow, which can be tracked through the body by the radiologist performing the esophagram.

Initially, the patients are asked to take a sip of the contrast, or dye, then hold it in their mouth until it is visible on the X-ray machine. Then, they are asked to swallow the contrast, and the radiologist charts its progress down the esophagus through the upper gastrointestinal system. Several pictures are taken to chart the flow of the contrast through the digestive system.

Post-operative swallow study
The procedure usually requires that patients swallow 4 to 6 mouthfuls of contrast. If the patient's flow is determined to be clear orders are then placed for their post-op diet to begin.

Step 8

Hospital discharge

Once patients are able to tolerate their new diet, they are able to go home. An occasional patient may need to stay an extra day or two for additional recovery time.

Step 9

First Follow-Up Appointment:

Somewhere between 10 days and two weeks after the surgery patients come in for a follow-up visit. At this time, patients receive instruction and counseling on transitioning to a soft diet. Other important behavioral changes are also reviewed, including eating slowly, increasing exercise and compliance with daily vitamin supplements. After surgery, patients begin a series of follow-up appointments.

Step 10

Patients begin a series of follow-up appointments with Dr. Stellato, Dr. Hallowell, or Dr. Jasper and the nursing team, that are spaced at intervals of two weeks, four weeks, three months, six months, one year after the surgery and yearly thereafter. The main purpose of these visits is to monitor the individual's revised eating habits, exercise regimen and progress of their weight loss. Lab work to check vitamin levels will be done at each visit.

Step 11

Post-operative patients and families are encouraged to participate in a regular series of Support Group Meetings that are for post-op patients only. Having been through the surgery and the substantial life changes afterwards, these individuals have different support needs. The meetings are structured to provide ongoing information to assist post-op patients in their recovery and ongoing lifestyle modifications as well as address any concerns, issues or problems that they have had. The meetings provide an open discussion forum for these people to discuss any related experiences or issues that they would like to cover.

Step 12

Post-op patients continue scheduling visits with the Bariatric Surgery Program team to monitor their continued health and progress in keeping their weight at the optimum level.

To learn more about the Bariatric Surgery Program at University Hospitals Case Medical Center, or to schedule an appointment with Dr. Stellato, Dr. Hallowell or Dr. Jasper, contact our Program Coordinators.