Surgical Program

The Bariatric Surgical Program provides comprehensive pre-operative, peri-operative, and post-operative surgical care led by an interdisciplinary team. The focus of this program is the treatment of obesity and obesity-related health conditions, safe weight management, and healthy lifestyle changes.

In order to be referred to the Surgical Program, patients will require a physician's referral.

Patients who meet the eligibility criteria are assigned to a Bariatric Centre of Excellence (BCoE) or Regional Assessment and Treatment Centre (RATC).

Eligible patients will be contacted directly by their assigned bariatric centre to attend an orientation session, followed by comprehensive screening and assessment by the interdisciplinary bariatric team to assess their appropriateness for surgery. Intensive education and nutritional counseling are provided prior to surgery. Following bariatric surgery, patients are monitored closely within the first year and thereafter within a shared care model with the primary care practitioner and the Bariatric Centre of Excellence.

The OBN has established standardized care paths based on current evidence and best practice that outline the minimal tests/assessments required pre-operatively for all bariatric patients in Ontario. Assessments may vary from person to person, depending on the individual and their health care needs in order to optimize health prior to bariatric surgery.

Eligibility:

• 18 years of age and older
• BMI greater than or equal to 40
• BMI greater than or equal to 35 but less than 40. With at least one of the following comorbidities (as determined by your physician):
  • Coronary heart disease
  • Type II Diabetes mellitus
  • Hypertension
  • Diagnosed sleep apnea
  • Gastroesophageal Reflux Disease (GERD)

Ineligibility (not limited to):

• Current drug or alcohol dependency (within 6 months of referral)
• Recent major cancer (life threatening, within last 2 years)
• Untreated or inadequately treated psychiatric illness

Before surgery, patients' care path includes:

• Program Orientation (Group Session)
• Interdisciplinary Bariatric Team Assessments which includes patient visits with:
  • Registered Dieticians
  • Social Workers
  • Registered Nurses and/or Nurse Practitioners
  • Medical Internists and other specialists (i.e. Psychology/Psychiatry) as deemed necessary
• Pre-Operative Testing involving routine blood work and additional diagnostic testing based on patients' individual medical needs. These diagnostic tests may include:
  • Ultrasound
  • Upper gastrointestinal series
  • Gastroscopy
  • Colonoscopy
  • Helicobacter Pylori Bacteria T
  • Pulmonary Function Tests
  • Cardiac Imaging
  • Cardiac Stress Test
  • Electrocardiogram
  • Sleep Apnea Study
• Bariatric Surgery Education Sessions (usually done in group format)
• Surgeon Consult and Consent
  • Patients may be on a low-calorie meal replacement at patients' own expense for 2-3 weeks prior to surgery
• Anesthesia Pre-Operative Assessment
• Surgery scheduled

After surgery, patients' care path includes:

• Post-operative visit at Week 1
• Follow up assessments at the following time intervals:
  • 1-month post-op
  • 3 months post-op
  • 6 months post-op
  • 1-year post-op
  • Annually up to 5 years post-op

Note: Patients' pre-operative and post-operative care plan may also include additional one-on-one intervention or visits with interdisciplinary team members, based on individual needs