[ UPDATED ON MARCH 2017 ]
Medical tourism is one of the most popular options today to get the desired health care in a country different than the one of residence because it is often cheaper.
One of the most popular destinations to get a gastric sleeve surgery for North Americans (USA and Canada) is Mexico, however, as this is an unknown country to most of those looking to have weight loss surgery, it can be a cause of concern, distrust and may trigger fears that most of the times are unfounded.
It may sound crazy but more than once our soon to be patients have asked us if they will go back home with both kidneys! When having gastric sleeve surgery in Mexico . This could not be farther from the truth, in Mexico there are strict regulations as to health care, similar to the ones in the United States.
In this article we share some pointers that you should consider to see if gastric sleeve surgery in México is safe in the location you are considering.
What the hospital you choose for your sleeve gastrectomy surgery should have
The hospital where you choose to get your surgery to be performed must have everything necessary for the proper care of a bariatric patient and the right equipment, both inside and outside the operating room. It is ideal that the place you choose, to be an actual hospital and not an outpatient facility that offers weight loss surgery.
A hospital usually has all the necessary departments and adequate infrastructure to meet any eventuality.
Bariatric hospital equipment
The hospital must have (in addition to the required in terms of safety, cleanliness and compliance with health guidelines):
- Intensive care unit
- Blood bank or blood availability if needed
Operating room for a gastric sleeve surgery
- Suitable surgical beds for bariatric patients
- Top of the line laparoscopic equipment
- Screens and laparoscopic HD cameras
- A Flawless anesthesia machine, with the capacity for ventilatory management of bariatric patients since they usually require more support during the procedure.
It is also equally important to consider that the place you choose has:
- Enough human resources at your disposal if necessary, by this we mean specialists in case your surgeon requires their support for your case.
- As a minimum there must be a cardiologist, pulmonologist and internist.
- Usually in the hands of an expert bariatric group these specialists do not get involved because patients have a smooth recovery and only give support during the preoperative assessment.
All this can’t be provided by bariatric groups with very low prices because the fee they charge do not allow them to have all of the above, and manage only to have the very basics, which can put your procedure and your health at risk .
Quality of the materials for your gastric sleeve surgery
It is a matter of common sense that everyone will want that the bariatric group you choose offers the best quality material available in the market, not in Mexico but worldwide. There are few companies developing the necessary surgical material for bariatric surgery that is of exceptional quality, and this is the material we use in Obesity Free.
In the market there are only two companies (Ethicon / Johnson & Johnson and Covidien / Medtronic) who develop the crucial material for the safe performance of gastric bypass and gastric sleeve.
Some of these unique materials are staplers that cut and seal the stomach and/or intestine. As you imagine if more "affordable" brands are used, the risk of complication is considerably higher.
This implies that the fact that if they offer you a very low price invariably represents a reduction in the quality of these materials since that “low cost surgeon” will not stop getting his usual income at the expense of using high quality material because a low price, can’t afford its use.
How to define a qualified bariatric surgeon?
At present there is a big competition among bariatric surgeons whose usually their competition is based on prices rather than focusing on the preparation of the surgeon that performs the procedures.
In our view, today it is no longer prudent to offer more than two or three bariatric procedures as to perform them with maximum success and fewer complications they need to be an expert on the subject. So those that offer gastric sleeve, gastric bypass, gastric banding, gastric plication, mini gastric bypass, duodenal switch, intragastric balloon, etc., they may know how they are performed and may have some experience on those procedures, but they will hardly dominate 100% all of them when splitting in several parts their field of expertise.
This is why I believe that to provide the greatest possible safety with the best results, your surgeon should be devoted to performing one, or at most two bariatric procedures since this brings him/her closer to the possibility of actually being an expert in that particular procedure.
At Obesity Free we are dedicated to offering only two procedures, gastric band and gastric sleeve. It should be noted that gastric banding is a procedure that is almost out from the bariatric surgery armamentarium for various reasons which we will discuss in another article. Currently 95% of our operations are gastric sleeves and only about 5% are gastric bands.
Speaking specifically of how qualified is your surgeon, it is not easy to determine, because now some trendy certifications have become popular and they do not reflect nothing more than the fact that the surgeon payed a good chunk of money to make their website to have a stamp or seal like: “surgeon of excellence” , or “center of excellence”, etc.
In these cases what really matters are the years of experience of the surgeon in the field of bariatric surgery in which it specializes, as well as belonging to internationally renowned nonprofit associations such as as:
- ASMBS (American Society for Metabolic and Bariatric Surgery)
- IFSO (International Federation for the Surgery of Obesity and Metabolic Disorders)
- SAGES (Society of American Gastrointestinal and Endoscopic Surgeons)
- ACS (American College of Surgeons)
Identifying an unreliable obesity surgeon
How to identify if the bariatric group you choose is of good quality is relatively easy considering the points that we have shared previously. It is important to analyze if what speaks well of him are his patients or himself, as even some surgeons call themselves "world-renowned surgeon." And the reality is that someone recognized worldwide is not in need of mentioning it on its website as their work would speak for them.
Another telltale factor for a bad bariatric surgeon is that if when contacting his office you find poor customer service, very few explanations and few questions, notable urgency on scheduling your procedure, etc. it is very likely it will be like that throughout the whole process if you're having surgery with that bariatric group. Also, if you want to speak personally with the surgeon and he/she does not take the time to talk with you and "know you" this is likely to continue the same way on the postoperative phase.
Finally, we emphasize again that the cost of a surgery of this magnitude cannot be too low, as this represents a reduction in hospital quality, material and/or the service you will receive.
Cheap gastric sleeves do not exist
As for the price of gastric sleeve surgery in Mexico, if the price for the package offered by the practice you are considering is too low (below $ 6,000) is wise to distrust whoever does this, since charging too low is probable that represents a reduction in the quality of service and materials used for your surgery, increasing the risks of complications and your investment.
We want to emphasize that although many websites offer cheap gastric sleeve surgeries, they surely represent a high risk of complications for your health, there is a big difference between affordable (in comparison to other countries) and cheap.
These drawbacks can be present before, during or after the procedure, what we mean by this? The low cost may be reflected in a poor preoperative assessment with minimally preoperative evaluation and testing or even none of these, no evaluations from specialties such as cardiology, pulmonology, internal medicine, endocrinology, nutrition, psychology, etc. Which eventually can result in serious operative complications or even death.
The importance of gastric sleeve postoperative diet
Postoperative diet is equally or even a more important step than the preoperative one since after the gastric sleeve surgery there should be a period in which you let your stomach heal properly before you can eat solids; non compliance of this crucial indication can put your health and even life at risk from developing a completely preventable complication.
The advantage of this phase is that the patient with gastric sleeve surgery will not have appetite or it will be much less than expected considering he/she will be eating only liquids. Actually we've never had a patient who has had trouble sticking to the diet if psychological and emotionally suitable, a patient who is not mentally and or emotionally prepared is not a good candidate for the procedure since it would represent a risk to themselves.
Many people ask what the postoperative diet after gastric sleeve is all about and after talking with patients from other bariatric surgeons we have concluded that there are highly variable guidelines to follow this diet, this will completely depend on the preference of your bariatric surgeon.
At Obesity Free, seeking the greatest possible safety for our patients, we offer a three week liquid diet, which ensures 100% that when you start with the intake of baby (pureed) food and solids, your stomach is already completely healed and there will be no risk gastric leakage.
Overall diet is as we list below:
- First Week: Clear liquid diet
- Second And third week: Full liquid diet
- Fourth Week: Baby food diet (pureed food)
- One month after surgery: Normal solid food diet
Logically postoperative gastric sleeve diet is much more detailed and specific, we provide this written information, with clear examples of what can be ingested in each of the phases so that there is no doubt.
In case of questions our patients are just a call away to clear them all at Obesity Free. Unfortunately from the questions generated in this blog we realize that many patients are not properly instructed and are left "alone" in this important stage of recovery, putting them at unnecessary risk.
If you want to know more details of postoperative gastric sleeve diet read this article: Post Op Gastric Sleeve Diet.
Postoperative follow up for the gastric sleeve procedure
Even though in the case of gastric sleeve surgeryit is not necessary to have frequent and close monitoring, it is recommended to keep close contact with your surgeon and make sure that if you have incidents, questions or concerns you will receive proper and timely attention.
One of the biggest advantages of the gastric sleeve surgery when we operate foreign patients is that this procedure does not require very close postoperative follow-up by the bariatric surgeon. We know that most prefer to have frequent checkups with their surgeon but the truth is that if there is adequate communication between the bariatric surgeon and patient, evolution usually goes without unforeseen events and in 95% of cases the discomforts are solved with the drugs we provide to our patients when discharged from our facilities.
Since we use absorbable sutures that go under the skin there is no need to remove stitches, besides, we do not place any drains so neither it is required the removal days or weeks later.
The only thing we recommend is that when they return to their hometown, to schedule an appointment with their family doctor and that he/she makes the proper suggestions in terms of modification of drugs to control diabetes, hypertension, hypercholesterolemia or any disease associated with obesity that the patient may suffer.
For a general health monitoring it can be seamlessly done with the help of your own PCP or Family Medicine practitioner at your place of residence and a year after having surgery is advisable to get a complete checkup with laboratory tests.
This is something that we certainly request to our foreign patients since the positive effects of the gastric sleeve in terms of improved blood sugar levels, blood pressure, etc. are reflected even within a few hours of surgery and this improvement is progressive until they reach a point where they can go into remission of these diseases.
As you have been able to observe, the risks and precautions concerning whether it is safe to have gastric sleeve surgery in México or not, are basically the same as in any other country if you take into account the points we mentioned in this article.
And yet, the potential benefits are numerous, so there are several reasons to consider surgery in Mexico as a great option so you can have your gastric sleeve surgery and therefore start a new healthier lifestyle.
The gastric sleeve procedure in México is totally safe, we invite you to get a free evaluation with us and share your questions about the gastric sleeve cost in México, side effects, etc.
[ UPDATED ON MARCH 2017 ]
Written by: Gabriel Rosales
Dr. Gabriel Rosales is a highly skilled, board certified surgeon in constant pursuit of learning the latest innovations in the weight loss surgery field to give his patients the best care possible.