Regional Bariatric Care Centre - Surgical Program

The Surgical Program at Thunder Bay Regional Health Sciences Centre (TBRHSC) offers surgical (bariatric surgery) treatment of obesity and weight-related complications through safe weight loss and management and support with maintaining healthy lifestyle habits.

For some, bariatric surgery is an option for obesity management.  Bariatric surgeries either cause some reduction in the amount of food you are able to eat comfortably or a reduction in the absorption of calories from the food you eat, or both.  While these surgeries can have major impacts on a person’s weight and other health-related factors, continued success and improvements in overall health still depend on maintaining healthy behaviours.

TBRHSC offers two types of bariatric surgery procedures:

Sleeve Gastrectomy – Here, surgeons will remove most of the stomach, leaving only a banana-sized vertical “sleeve” of it in place.

Gastric Bypass – A small stomach pouch is created using surgical staples, which allows food to bypass some of the small intestine.

How to Talk to Your Doctor About Bariatric Surgery

Benefits of Bariatric Surgery

With appropriate patient selection, education and follow up, bariatric surgery can offer sustainable weight loss (20-30% reduction) with large reductions in weight-related complications and significant improvements in mental health and quality of life.

*Specific outcomes include:

  • Independence and enhanced mobility
  • Up to 94% resolution of high cholesterol
  • Reduction or elimination of some chronic pain
  • Greater than 80% resolution of type 2 diabetes
  • Reduced need for medication
  • Greater than 90% resolution of liver disease
  • Improved cardiovascular health
  • Greater than 75% resolution of sleep apnea
  • Reduced risk of acquiring serious diseases
  • 41% resolution of arthritis
  • Improved changes of fertility
  • 80% resolution of high blood pressure

*Individual results vary

Eligibility for Bariatric Surgery

Eligibility criteria for bariatric surgery include:

  • 18 years of age and older
  • Body Mass Index (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 co-morbidities (as determined by your primary care provider:
    • Coronary heart disease
    • Type II diabetes mellitus
    • Hypertension (high blood pressure)
    • Diagnosed sleep apnea
    • Gastroesophageal Reflux Disease (GERD)

Ineligibility for Bariatric Surgery

Ineligibility criteria for bariatric surgery include (but are 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
  • Smoking or vaping nicotine or cannabis (including cigarettes, cigars, e-cigarettes) within 6 months of referral

Bariatric Surgery Frequently Asked Questions

Bariatric Surgery – What to Expect

Before surgery

Once you are referred to the program, our program clerks will start coordinating your journey.  You will be contacted to attend an orientation session to learn if bariatric surgery is a suitable option for you.  If you choose surgery, you will be assessed by our team.  You will be expected to attend multiple appointments (some appointments can be done virtually) so the team can assess and prepare you for surgery.  The assessment process starts with a medical intake appointment with our Internal Medicine Physician.  You will be required to have bloodwork and an electrocardiogram (ECG), and you may have to do other test(s) to make sure you are safe to have surgery.  After you see the doctor, you will be assessed by our support team, including a nutritional assessment by the dietitian and psychosocial assessment with the social worker and/or Psychologist.  There will be many opportunities to ask questions during these appointments. You are welcome to bring a support person to any of these appointments.  Missing multiple assessment appointments before surgery will result in discharge for 1 year.

The surgical care team also includes nurses and a kinesiologist (exercise specialist). We have 2 surgeons who perform the bariatric procedures:  Dr. Scott Cassie and Dr. Andrew Smith, who we welcomed to our team in 2014.

Bariatric surgery is a life-altering procedure, and is usually not reversible. For that reason, the RBCC team provides a thorough assessment to make sure that all patients know the risks, potential outcomes and benefits, as well as assesses the patient’s physical and emotional readiness to determine eligibility.  You want to carefully consider if this is the right time to make this type of lifelong commitment.

At the medical intake appointment

You will be greeted first by one of our nurses, who will take some measurements from you before you see the doctor. The nurse will measure your height and weight to confirm or update what was received on your referral. They will measure some vital signs such as your blood pressure. The nurse will also measure around your waist. This is called “waist circumference” and research shows that it can identify patients at increased risk for certain diseases. The size of your waist often decreases after losing weight and can show how your risk for these diseases is decreasing over time. You can discuss this with your team at any time. Some patients say they feel embarrassed to have their waist measurement. Our nurses will do their best to make you feel comfortable and let you know when it is time to take this measurement. They can explain why this is important and answer any questions you have.

The doctor will review your health history and ask you about any past surgeries you have had. They will examine you in the same way that your family doctor or nurse practitioner does. The doctor may order other tests such as tests to check on your heart, or breathing or other things to make sure you are safe to have surgery.

After surgery

You are expected to have regular follow up with our clinic in the first year after surgery to help you adjust to your new lifestyle.  You may be transitioned to your primary care provider or nurse practitioner after the first year, when appropriate (as determined by the team).  The bariatric team will remain available if you need support.  Lifelong support is important to help with your healthy lifestyle decisions but also to screen and monitor you for any medical, nutritional and/or emotional side effects and complications.  You are expected to take vitamins (up to 3 times/day) every day for life, as well as have bariatric bloodwork done every year for the rest of your life.

Support Group

Groups are offered regularly, and run by clinic staff.  This is an opportunity to connect for conversation about healthy lifestyle and promote peer support while gaining knowledge and sharing experiences.  The support group is available to patients before and after surgery.  Call our clinic for more information, or to register (807) 684-6058. (email address and computer/tablet/smart phone are required to attend)