Arch Bariatrics we perform all surgeries laparoscopically

1. Education:

At Arch Bariatrics , we recommend that you attend a seminar to learn about weight loss surgery and see if you qualify. You can do an in person seminar (attend a seminar) or contact us to learn about online seminar.


2. Consultation and Pre op Evaluation:

During your initial consultation, You’ll have an opportunity to meet Dr.Kumaran Chinnappan, our dietician and patient advocate.You will discuss your medical history, your surgical options, and any questions you have about the surgery.

  •       What Should You Bring?

Our Medical history Form— this may be printed out and completed in advance.

Insurance card

Photo ID

Any questions you have about weight loss surgery or the process.

  •     Your Preoperative Evaluation

Preoperative testing and evaluation is essential for obtaining the best surgical weight loss results. We’ll conduct and evaluate a series of routine medical tests prior to your surgery. Additionally, this is required by most insurance providers before they’ll approve your surgery.

Your personal doctor or another medical specialist may be asked to provide “medical clearance” prior to your surgery.

After the results of your tests have been reviewed, you’ll be contacted with a date for your surgery. We’ll also provide you with additional guidelines to help you prepare for surgery.


3. Prepare for Surgery:

You’ll receive your scheduled date of surgery after your insurance company grants your approval. But we’ll be here to assist you throughout the approval process as well.

You’ll begin preparing for your bariatric surgery about three weeks before the big day. To ensure everything goes as smoothly as possible, follow the guidelines below.

  • 2 – 3 Weeks Before Surgery:

You’ll report to the hospital for pre-admission testing as an outpatient. You’ll undergo specific blood tests, a chest x-ray, and an electrocardiogram (EKG). Your bariatric surgeon will answer any questions you have about these tests.

  • 1 Week Before Surgery:

Do not take aspirin, ibuprofen (e.g., Advil, Motrin), Coumadin and Plavix. All of these drugs tend to cause increased bleeding during surgery. If you are taking any of these drugs, please notify Dr.Kumaran Chinnappan.

Follow the calorie free diet as advised during your office visit with our team.

  • 1 Day Before Surgery:

The admitting office will contact you with the scheduled time you should arrive at the hospital. Usually this will be 2-3 hours prior to surgery.

Drink only liquids (no solid food).

Do not eat or drink anything after midnight the night before your surgery.

Take a bath or shower  the night before surgery or the morning of your operation.

  • Packing for Your Hospital Visit:

Depending on the type of surgery you have chosen, you can expect to stay at least one night in the hospital. Please bring comfortable clothing, magazines and a good book for your stay.

  • The Day of Surgery :

The doctor will meet with you before you are anesthetized.

You will remain under the effects of general anesthesia during the entire procedure.

Your family and friends are welcome to wait in the surgical waiting room of the hospital during the operation. They’ll be able to speak with the surgeon shortly after the operation is completed.

  • How long does the operation take?

Gastric banding (LAP-BAND) is usually performed in under 1 hour, while Sleeve Gastrectomy and gastric bypass is generally performed in 1.5 to 2 hours. It could take longer based on the complexity of the clinical condition.

  • Admission to the Hospital:

Most patients spend 1-2 hours in the recovery room before returning to their room on the surgical floor. It is typical for patients to go home the same day after Gastric Banding Procedure. After, Laparoscopic Sleeve Gastrectomy or Laparoscopic Gastric Bypass surgery all patients will be admitted to the hospital for at least one night.

After you are completely awake from the effect of the anaesthesia, we encourage you to be out of bed and walk in the corridor. Ask for pain medications if needed. You will be taught and encouraged to do breathing exercises and incentive spirometry.

An Upper GI Xray will be performed next morning to evaluate your stomach. You will be started on diet. It is not uncommon to experience nausea and even vomiting initially. It tends to get better slowly through the day. In most instances one can expect to be discharged later in the evening.


4. Bariatric Surgery Recovery

You can expect to be discharged from the hospital about 1-2 days after your bariatric surgery.

It is not uncommon to feel weak and tired for a few days after your discharge from the hospital. Your body is still recovering from the stress of surgery. Additionally, the feeling of weakness may be prolonged as your body begins to shed excess pounds.

  • Discharge Instructions 

-You may shower at your leisure.

-Do not drive as long as you are on narcotic pain medications.

-Do not attempt any strenuous activity, particularly heavy lifting, for approximately 4-6 weeks.

-Walk as much as you wish, and climb stairs, as you need to.

-You can return to work anywhere from 1-4 weeks after bariatric surgery. Time you return back to work will be determined by the kind of work you do and how physically demanding it is.

  • Follow-Up Care

Postoperative bariatric follow-up care after any weight loss surgery is extremely important.We want your bariatric surgery and weight loss efforts to be as successful as possible, and we know you feel the same. To this end, we cannot stress the importance of follow-up care enough. Patients who regularly keep their follow-up visits almost always lose more weight than those who skip their follow-ups.

Follow up visits help us to evaluate your diet patterns. Your follow-up visits are also necessary to help us recognize vitamin and iron deficiencies in the early stages of your weight loss so that appropriate treatment can be given. If you miss your regularly scheduled follow-up visits and the required postoperative blood tests, you can eventually develop vitamin and mineral deficiencies. Severe deficiencies may require shots or blood transfusions. In addition we recommend that you attend support group meetings.

  • First visit: Scheduled 1-2 weeks after bariatric surgery.
  • Second visit: Scheduled 4-5 weeks after bariatric surgery. A new solid diet is prescribed.
  • Quarterly visits: Scheduled at approximately 3-month intervals for the first year after the operation.
  • Annual / biannual visits: Scheduled at 6-12 month intervals after the first year. Follow-up will continue annually for an indefinite period of time.


  • Diet and Nutrition  

 Immediately after surgery you will be on a liquid diet, moving to soft foods and finally onto regular food. Dietitians will provide you with a specific food plan. When returning to regular food, keep in mind these general guidelines

-Eat proteins first.

-Eat slowly. It takes time for your brain to realize your stomach is full. Eating fast can lead to overeating.

-When you start eating solid food, it is essential that you chew thoroughly.

-Don’t drink fluids while eating. They will make you feel full before you have consumed enough food.

-Omit desserts and other items with sugar listed as one of the first three ingredients.

-Avoid liquid calories. Omit carbonated drinks, high-calorie nutritional supplements, milk shakes and high-fat foods etc.

-Limit alcohol intake.

-Limit snacking between meals.

-Using measuring spoons and measuring cups with each meal to start to understand portion control.


5. Insurance and Payment

  • How much does bariatric surgery cost?

For many people, weight loss surgery is an affordable health option because it is covered by their health insurance plan. These benefits usually cover the majority of the surgical costs, however there may be out-of-pocket expenses depending on the procedure and your insurance policy.

Understanding your insurance and payment options is often one of the most difficult parts of the weight loss surgery process. Fortunately our staff are well versed in the insurance process. We’re ready to help you get approved for surgery and discuss your billing and payment options.


  • Approval for Weight Loss Surgery

In recent years, the insurance companies have made it more difficult for prospective bariatric patients to be approved for surgery. Every insurance policy is different, but most require similar information to help determine your medical necessity.

If you’ve discovered that you qualify for surgery, we should be able to work with you to ensure you’re approved for surgery. However the approval process will take some time.

In the event of an unjustified denial of coverage, we’ll continue working with you to help overturn your insurance provider’s decision.


  • Insurance Options

Arch Bariatric LLC accepts most major insurances but bariatric coverage for each individual policy varies by company and employer. To avoid misunderstandings regarding your health benefits, we recommend you work with Arch Bariatrics staff to determine your exact coverage. Our staff are experienced and are able to work with many insurance companies to authorize and pay for most of the hospital charges and surgeon fees. Our preference is for you to use your insurance to avoid the significant hospital and other related costs. Visit our Contact Us page to request more information.


  • Self-Pay Options

If your health insurance doesn’t cover your weight loss surgery or fails to approve you for the procedure (or if you don’t have health insurance), Arch Bariatrics has other payment options available. Our billing specialists are happy to discuss our self-pay options and costs with you. Additionally, if money’s an issue, our staff can advise you regarding financing and credit application.


6. Life After Surgery:

Following bariatric surgery, your weight will come off gradually. Your greatest weight loss will occur during the first several months after the operation.

Over the long term, we stress consistency of weight loss rather than the speed at which the pounds come off. After a few months, your rate of weight loss will gradually decrease. This is normal. It happens because the weight which is lost is fat (adipose tissue) rather than lean body mass (muscle). Hence, the more fatty tissue that is lost, the less remaining fat on the body that there is to be lost.

  • Attend follow-up visit with the doctors and support staff at Arch Bariatrics.
  • Eat smaller portions and stop when you feel full.
  • Choose healthier foods for better nutrition. Proper nutrition is essential after weight loss surgery.
  • Take vitamins and minerals replacements as advised.
  • Exercise regularly doing the physical activities you enjoy most.
  • Participate in support group meetings both in person and online.
  • Celebrate your weight loss success with friends and family (but not with food!)


  • Your Medical condition

Obesity-related medical problems will likely improve with a modest degree of weight loss after your surgery. Blood pressure, blood sugar (glucose) in diabetics and blood fats (cholesterol and triglycerides) in patients with hyperlipidemia need to be monitored regularly. You’re encouraged to see your own medical doctor at regular intervals after the operation, particularly for adjustments in any medications you take. With steady weight loss, patients often require lower doses of medications for diabetes and high blood pressure. With a little luck, you won’t require any medications for these problems after achieving a substantial amount of weight loss.


  • Pregnancy After Bariatric Surgery

Women are strongly urged to postpone planned pregnancy for the first 18 to 24 months after weight loss surgery. We recommend using the most effective forms of birth control during that period. The first two years after surgery is when the most weight is lost and getting pregnant during this time could put the baby in danger and dramatically reduce weight loss. Pregnancy places many demands on the body and the developing fetus can be harmed by the lack of nutrients and calories. If pregnancy occurs, vitamin and mineral deficiencies should be corrected with strict follow-up. If not corrected, these deficiencies can adversely affect the baby’s health.


  • Do I need Plastic Surgery after Bariatric Surgery?

At Arch Bariatrics, we view weight loss surgery as an effective way to improve your health through weight loss. Cosmetic improvements are not the main intention of the surgery but a side effect that many of our patients like!

Not all patients will need plastic surgery after weight loss surgery. While exercise can help tone muscles, unfortunately in some cases, no amount of exercise will get rid of sagging or excessive hanging skin caused by major weight loss.

  • If you find that you have excessive sagging or hanging skin around the abdomen after weight loss you may be a good candidate forpanniculectomy. During a panniculectomy, surgeons will remove excess skin in your abdominal area, called the pannus, which causes an apron-like overhang.
  • Whereas a panniculectomy removes just excess skin around your middle section, a tummy tuck removes excess skin and also involves tightening of the abdominal muscles under the skin in most cases. If you are concerned about having a firmer, smoother stomach after weight loss, a tummy tuck (also known as an abdominoplasty) is more likely to give you the results you desire.
  • Body contouring after major weight loss removes excess skin and fat and improves the shape and tone of your underlying tissue in areas such as Upper arms, Breasts, Buttocks, groin and thighs. The result is a more normal appearance to the body, with smoother contours.

Panniculectomy, tummy tuck and body contouring are not substitutes for weight loss or exercise. Patients who’ve lost weight should be at least 12-18 months post-op and have reached their goal weight prior to having cosmetic procedures and skin removal.

Arch Bariatrics LLC before and after weight-loss surgery
Arch Bariatrics LLC before and after weight loss surgery
Arch Bariatrics LLC before and after weight loss surgery

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Arch Bariatrics we look at several factors when determining whether you are an ideal candidate for weight-loss surgery
Arch Bariatrics of St. Louis