Below are some common questions about preparations before surgery based on the hundreds of people we have treated. If you have any further questions, please arrange a free, no obligation consultation below.

What happens during my consultation?

During your initial appointment with Mr Alkhaffaf, you will have the opportunity to discuss all aspects of your care and have all your questions answered. Before your appointment, we will ask you to complete an online questionnaire to support this process. Mr Alkhaffaf will discuss the different options available to you and ensure that you are offered choices tailored to you.

The initial consultation is free, and there is no obligation for you to proceed with treatment. Sometimes, follow-up appointments are required before you can proceed with your treatment. These are also free of charge and will be arranged at your convenience.

Consultations can be arranged to take place face to face, virtually (video call) or over the telephone. This gives you added flexibility allowing you to fit in the consultation around your commitments.

What tests will I need to have done before surgery?

All patients receive a comprehensive pre-operative assessment which aims to make sure that surgery is carried out safely. This includes psychological assessments, medical background checks, blood tests, swabbing (for MRSA and COVID-19) and a heart tracing.

On rare occasions, new medical conditions that patients were previously unaware of are discovered. These may require additional investigation and treatment that could result in the postponement of surgery. The pre-operative assessment may also indicate that you require care in a High Dependency Unit. If this is the case, then this and any additional associated costs will be discussed with you.

Whilst not routinely performed in the UK, gastroscopy (a camera examination of your oesophagus and stomach) can be useful in identifying conditions for which you do not have symptoms. This may help us to better plan the most appropriate surgery and treatments for you. You have the option of undergoing a gastroscopy prior to surgery by asking your GP for a referral through the NHS or at additional cost to you if you wish to pursue this option privately.

What COVID-19 precautions do I need to take?

The safety of our patients is paramount. All precautions which our hospital partners take aim to reduce the risk to you and other patients of problems linked to COVID-19 infections. These include asking you to have a COVID-19 swab and asking you to isolate at home for at least three days before surgery. This guidance may be changed depending on the rules at each facility and non-adherence places you at risk of your surgery being postponed.

We advise all our patients to ensure that they have been vaccinated to reduce their risk of developing COVID-19.

Do I need to lose weight before surgery?

Most people do not need to lose a specific amount of weight before surgery. However, in some cases, it may be necessary to set a weight-loss goal before surgery to ensure that a procedure can be carried out safely. This is especially the case if your BMI is greater than 50.

How long will I need to go on a liver reducing diet (LRD) for?

The liver lies directly over the stomach and must be moved aside during surgery to safely complete weight-loss surgery. We ask patients to strictly adhere to a liver reducing diet (LRD) to shrink the liver which allows it to be gently retracted more easily during surgery.

The details of this diet and how long you should adhere to it will be provided to you ahead of surgery by the team. Generally speaking, there are three types of LRD which can be followed. These include a ‘milk and yoghurt diet’, ‘fluid-based meal replacement’ or ‘food-based diet’. Each of these aim to limit the calorie intake to approximately 800kcal a day, reduce carbohydrate and fat consumption and increase protein intake.

If the liver diet is not adhered to, there is a risk that surgery becomes more technically challenging and that it cannot be completed as planned. As this will not be known until during the time of surgery, you may be liable for any costs incurred, including a portion of the hospital, surgeon and anaesthetic fees.

Do I need to let my doctor or medical team know I am having surgery?

We strongly advise you to let your GP know about any intentions to pursue weight loss surgery. Your GP practice will play an important role in prescribing medications and undertaking blood tests after your procedure. Giving them prior notice of your intention is good practice.

If you suffer from conditions that are under the care of specialist medial teams or that require medications, it may be necessary to inform them prior to surgery. Pre-existing conditions may impact on the type and timing of the procedure you can have. Weight-loss surgery can also impact on how medications are absorbed by the body. If this is the case, Mr Alkhaffaf will directly contact the medical team or GP for further assistance. It is therefore important for you to have the names and contact details of relevant medical teams ahead of your consultation.

Do I need to stop smoking before surgery?

If you smoke, you will be required to stop at least 6 weeks before surgery and commit to not starting again in the future. Smoking increases the risks of serious complications around the time of surgery, such as poor healing and staple leaks. Smoking also increases your chance of developing stomach inflammation and ulcers in the future.

These rules also apply to vaping (electronic cigarettes) with nicotine in them. Your smoking history may also impact on the type of procedures you are offered.

Do I need to stop medication before surgery?

We generally ask you to continue most medications around the time of surgery. However, there are certain medications which will ask you to stop ahead of your procedure:

• Blood thinning medications (e.g. warfarin, aspirin, clopidogrel, apixaban)
• Immunotherapy medications (e.g. those used with rheumatoid arthritis)
• Steroids
• Some anti-inflammatory medications (e.g. Naproxen)

A clear management plan for the use of these medications will be provided to you well ahead of any surgery.

Should I stop my contraceptive pill or HRT before surgery?

Contraceptive pills and HRT are used commonly by patients undergoing surgery. Largely, these can be continued safely around the time of surgery. However, patients should be aware that the combined oral contraceptive pill (which contains oestrogen) and HRT can increase the chances of developing clots in the leg. Whilst our enhanced recovery programme ensures that everyone is given medication to reduce this risk, patients are given the choice to discontinue the combined pill and HRT if they wish.

Following surgery, the absorption of some medications, including the oral contraceptive pill can be altered. We therefore advise you to consider alternative methods of contraception such as implants, barrier methods (such as condoms) or intra-uterine devices.

When do I have to pay for surgery?

You will be required to pay the entire fee before surgery can proceed. The cost of the procedure will be collected by one of our hospital partners, usually two weeks before surgery. If you cancel your surgery at short notice, you will be liable for any costs incurred such as a pre-operative assessment.

Many of our patients decide to part fund their surgery using finance loans. These can be arranged through our hospital partners’ self-pay offices or through alternative third party groups. Please contact the office should you require any further information about paying for your treatment.