Metabolic & Bariatric
Sugery

By your side on your journey to a new begining.

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Procedures

Your health is our #1 priority

Gastric Sleeve

$4,000

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Gastric Balloon

$2,300

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One Anastomosis Gastric Bypass

$5,000

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Roux-en-Y Gastric Bypass

$6,000

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Endoscopic Gastric Sleeve

$6,500

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Documentation

Metabolic &
Bariatric Sugery

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1. MBS is recommended for individuals with BMI 35 kg/m2, regardless of presence, absence, or severity of comorbidities.

2. MBS is recommended in patients with T2D and BMI 30 kg/m2.

3. MBS should be considered in individuals with BMI of 30–34.9 kg/m2 who do not achieve substantial or durable weight loss or co-morbidity improvement using nonsurgical methods.

4. There is no upper patient-age limit to MBS. Older individuals who could benefit from MBS should be considered for surgery after careful assessment of co-morbidities and frailty.

5. Carefully selected individuals considered higher risk for general surgery may benefit from MBS. Children and adolescents with BMI. 120% of the 95th percentile and a major co-morbidity, or a BMI. 140% of the 95th percentile, should be considered for MBS after evaluation by a multidisciplinary team in a specialty center.

FAQ

What is pre-operative diet?

Your specific pre-op diet is determined by the nutritionist and surgeon once you are scheduled for surgery. Once you are serious about moving forward and have scheduled a date this will be provided to you with a specific timeline and details. The diet focuses on a combination of high-protein meals and protein shakes, while eliminating carbs and sugars.

The pre-op duration and menu is determined on various factors:
• BMI
• Procedure
• Bariatric Surgery History
• Goals

What is the purpose of the pre-operative diet?

The purpose of the bariatric surgery pre-operative diet is to aid in a successful surgery. The main goal typically is to shrink your liver so the doctor can access your stomach easier. Sometimes weight-loss goals will be established by the doctor for certain procedures or BMIs. The diet is critical for preparing your body physically and mentally for the procedure and post-op preparation.

Will my surgery be canceled if i do not follow the diet?

Not following the diet will make the surgery harder for the surgeon. Mistakes are ok, but we do encourage strict adherence and getting back on track as best as possible.

Occasionally, certain goals for clearance are established and communicated to specific patients for a BMI over 50 or certain procedures, in this case yes it does put you procedure in jeopardy. We will get medical team in touch.

Do I have to stop smoking before surgery?

Yes, you must stop smoking a minimum of 30 days before surgery. This includes the patch, nicotine gum, nicotine vaping (0% (no nicotine) vape is ok). Nicotine of any form can cause slow healing and leaks.

Post-Operatively this is important as well for minimum of 4 weeks, smoking can cause clotting and slow healing.

What pre-op test should I get at home?

Unless you have a specific concern or our doctor’s have requested a specific test or information for medical clearance no pre-op testing is required at home.

Do you have any more questions?

Which size bougie do you use?

The bougie size will typically 36 French. Your bougie size will be performed and selected at the discretion of the surgeon based on the anatomy of each patient, medical history, patient risk, various other factors.

• What is the Bougie – calibrated tube inserted in stomach endoscopy through the trach used as guide for cutting and stapling along to measure and form new pouch. Provides structure and size of new stomach. • 36F for us equals safe potential for maximum weight loss – balance of safety and results. • US Surgeons via insurance: Typically >40 (smaller bougie equals more complications).

*No guarantee is made on size, it will be selected at the discretion of the surgeon based on the anatomy of each patient, medical history, patient risk, various other factors.

Do you use a six lie or four-line staple line?

All of our bariatric surgeons use a six-line staple gun, which produces lowers rates of staple line leaks.

How many leak tests are performed?

Yes, leak tests are completed and passed prior to discharge.

Tests are done in the OR – a blue dye test and a PSI test with air to identify any leaks prior to leaving OR.

A final leak test is performed outside of the OR with a barium swallow via x-ray. The x-ray will be provided to you upon discharge.

What anesthesia is used?

A variation of General Anesthesia (patient is fully sedated/asleep) is used and is specific to each patient but typically: Propofol, Fentanyl and Vecuronium, followed by Maintenance Oxygen + Desfluorane.

For Gastric Balloon Procedure: Twilight sedation.

How many incisions will I have?

4-5 depending upon how well you have done on your pre-op diet.

Doing the pre-op diet well can eliminate incision for the liver retractor.

SILS incision above/at belly button plus drain.

What time will my procedure be?

Surgery times are not determined until the day of surgery and vary based on various factors each day:

• OR schedule (other doctor’s schedules and delays and emergencies)
• Arrival Time
• Pre-op testing completion
• Anesthesiologist determines order of patients after blood work is complete
• Surgeon orders patients based on various factors: complexity, BMI, bloodwork and etc.

Do you have any more questions?

How long should I take off work?

Varies based on your job.

Suggested:
• Desk Job: 1 week
• Physical job w/o lifting, bending, twisting: 2 weeks
• Physical job w/ lifting, bending, twisting: 6 weeks

How long for lifting?

Please wait at least 6 weeks for lifting over 10-15 lbs.

How long for exercise?

6 weeks no lifting, bending, twisting or exercise other than stationary bike or walking is permitted immediately provided you are getting 64oz of water and 2-3 protein shakes a day, otherwise your body does not have enough energy to expend.

How long for swimming or bathing?

Incisions should be fully healed – approximately 4 weeks. Until this time do not submerge the incision in water.

Do you have any more questions?

What is the age requirements for weight loss surgery?

The age requirement is usually a minimum age of 18 and a maximum age of 64. Please contact us today to learn more – there are some exceptions, but it’s a case by case basis.

Do we accept CareCredit?

No. CareCredit does not allow/ will not accept from ANY providers in Mexico.

Costo de la cirugia?

Desde 4000 dolares

Hola Quiero saber el precio

Va desde lo 3000 dolares

Do you have any more questions?

Are passports required to travel to Tijuana?

U.S. Citizens: Nieto Bariatrics highly recommends patients use a passport, but it is not required if you’re a U.S. citizen and going to Tijuana, Mexico. For patients traveling to Cancun, a passport is required.

If you’re a U.S. citizen you can travel to Tijuana without a passport. However, you will need to show proof of citizenship.

Proof of citizenship can be shown with an original birth certificate issued by a U.S. government agency (not a hospital copy and not a copy of the birth certificate) and a valid government-issued ID.

Passport cards and enhanced driver’s licenses are also acceptable forms of documentation.

U.S. Citizens born outside of the U.S.: Will require a valid U.S. passport for travel or an original naturalization certificate along with a valid government issued photo ID.

U.S. Permanent Residents: Will require a valid Permanent Resident card, also known as a Green Card, with a valid government-issued photo ID or a valid passport from their country of citizenship.

Puerto Rico Patients: must have a valid U.S. passport or a valid government-issued photo ID along with an original issued birth certificate. Birth certificates issued prior to July 1, 2010 are not accepted by U.S. Customs and Border Protection.

Canadian, European, Australian, New Zealand citizens: a passport is required.

What are the departure times? why?

Departure time is 12pm or after from hotel.

If departing from hospital – 2pm or after.

This time is established because of time to get to the airport because of the following conditions:

• Medical Pass Lane opens at 8am.
• Border Crossing (especially in the mornings) can take 2+ hours.
• Must arrive at the airport 1.5-2 hours early.

If departing before 12pm it is required to stay in San Diego the night prior, especially for early morning flights, the crossing can take up to 2+ hours.

You can select a hotel with a shuttle or take Uber to the airport from the hotel you select.

What if I want to stay an extra day to be safe?

While almost all of our patients stay only the 3 nights and are not really needed as well as discouraged most patients enjoy recovering in their own beds, staying an extra day in Tijuana or San Diego is permitted.

Departure times still apply for extra Tijuana days.

Tijuana extra nights are $100 extra and subject to availability (must notify coordinator ASAP – coordinator indicates the extra hotel according on AC).

The driver can also drop you at a San Diego hotel. Hotels with shuttles or Uber/Taxi will be required for airport return.

What is the name of the hotel?

Tijuana: Hotel Quartz https://www.quartzhotel.mx/
Info | 800 824 0000 | (664) 862 8200 | info@quartzhotel.mx
Address: Ave. Paseo del Centenario 9580, Zona urbana Río Tijuana, B.C. C.P. 22010 B.C., Mexico

Tijuana: Grand Hotel https://grandhoteltj.com.mx/
Info | 866 472 6385 | 866 495 1879 | marketing_coord@grandhoteltj.com.mx
Address: #4558 Col. Aviación C.P. 22014 Tijuana, B.C., México.

Can I fly directly to Tijuana?

Yes but please be advised of following:

• On own for immigration
• Must have a passport
• Have about 6 check points
• The lines standing for immigration after surgery are intense as well
• Usually flights into Tijuana go thru Mexico City which is 6 hr flight as well

Is the border safe and/or crossable?

Yes, we have not had any issues, nor do we plan to.

In the event that it were to close we have an alternate crossing about 20 minutes away.

We will always insure a way and your safety.

Do you have any more questions?

Reviews

    
 
 
        
   Iveth Hernandez 
 2024-08-08
 
 
 Trustindex verifies that the original source of the review is Google. Excelente Dr , junto con su equipo de trabajo! Hospital súper cómodo y el personal de salud súper atentos y amables !! Muchas gracias Dr Nieto y su equipo hacen una grandiosa labor y equipo impecables !
  
 
       
   David Estrada 
 2024-08-06
 
 
 Trustindex verifies that the original source of the review is Google. Excelente atención y seguimiento!!!! Recomendado
Llevo dos meses y los resultados han sido increíbles. Todo el proceso ha sido mejor de lo que esperaba
  
 
       
   Irene Stein 
 2024-07-29
 
 
 Trustindex verifies that the original source of the review is Google. I recently had a gastric sleeve surgery performed by Dr. Nieto and his wonderful team at Dreams Hospital in Tijuana, Mexico. I was picked up in San Ysidro by his driver Alvaro, who was very friendly and helpful with my luggage. Alvaro drove me directly to the hospital where the security guard let me in to the elevator and up to the lobby where I was checked in by a helpful hospital staff member. A second staff member came and went over the forms with me and obtained my signatures, answering any questions (which I did not have many of since I had already met with Dr. Nieto and the nutritionist Maggie prior to scheduling the surgery). My first official hospital step was bloodwork with a very skilled phlebotomist directly off the hospital lobby. She took several vials of blood without any discomfort on my part. Next, I was escorted upstairs by the same staffer who introduced me to the nurse on shift assigned to me. I was weighed and my height measured before being shown to my room where a gown was waiting in n the bed. The room was very large with one wall all windows overlooking the city. There was a large closet with storage and an electronic safe, a desk, and a couch/futon that a companion can sleep on. The restroom was large with a shower as well as toilet and sink. Every room is private, and the nurses and doctors always knock before entering. I was provided with compression socks to wear as well. The nurse placed my IV and made sure I was comfortable and settled in. I arrived the same day as my surgery, and I saw several other doctors who assessed my health and mental state before Dr. Nieto arrived and greeted me before starting his surgeries for the day. I was the second of 3 patients. He was very friendly and showed high energy and spirits with no signs of being overworked or tired. The operating room and recovery room staff are separate from the main hospital staff, and they were helpful as well. Dr. Nieto checked in with me again right before surgery to make sure I was ready. Inside the operating room, I met the anesthesiologist who was very helpful as well and provided necessary details about his role in the procedure. The OR nurse was very helpful as well and comforting. After the surgery (about 40 minutes), I was in the recovery room for about an hour before being taken back up to my room. I was very groggy, and the staff were very helpful in getting me back into my hospital bed and comfortable. Within an hour, I was up on my feet. My stomach was very sore and the gas that is pumped into the abdominal cavity so the doctor can see everything is very uncomfortable. Getting up and walking around helps with that a lot. I made a point to follow Dr. Nieto’s recommendation to walk 10 minutes every hour, and it really did make a difference. The next morning, I felt even better and had much less soreness. It was so easy to get up and walk around. I kept the compression socks on the entire time I was in the hospital. Great support by the nurses, and the custodial staff were great as well, coming twice a day to clear the trash and make sure the room was clean. My stomach incisions were cleaned each day by the nurses, and I was educated on how to provide proper at home care for myself before being discharged. Dr. Nieto checked in on me before I left on day 3, and I was given very clear dietary guides by Maggie the nutritionist as well as medications and answers to any other questions from Miguel. I highly recommend to anyone thinking about getting this surgery in Tijuana. I am from California and know very little Spanish, and I had a great experience and would do it again exactly the same way if I had to!
  
 
       
   STEPHANIE VILLALOBOS LOPEZ 
 2024-07-27
 
 
 Trustindex verifies that the original source of the review is Google. Excelente personal 🙏🫰
  
 
       
   Aletzya Jauregui 
 2024-07-12
 
 
 Trustindex verifies that the original source of the review is Google. La atención es muy rápida y aclaran todas tus dudas, te comparten la información que necesitas saber y entender de la cirugía, el doctor es muy claro, el hospital en Ensenada súper bien, la atención del hospital y sus instalaciones son muy buenas, la verdad que todo el equipo del doctor se portó súper bien conmigo, y me fue muy bien con mi cirugía.

Estoy muy contenta con mis resultados y el seguimiento.

Gracias Doc.
  
 
       
   Louise Cerna 
 2024-07-11
 
 
 Trustindex verifies that the original source of the review is Google. After months of researching and consulting with doctors I chose Dr. Nieto and it was the BEST decision I’ve ever made! His ENTIRE team is AMAZING! Starting with Anika (the coordinator), Maggie (Nutritionist), and Alvaro (transportation), were exceptional! Dr. Nieto and medical team exceeded all of my expectations. Dr. Nieto’s patience, his technique, his theology of bariatric surgery is why I went with him and I’m so glad I did! My recovery was the best! No issues at all! The nurses and staff took very good care of me and made sure I felt comfortable at all times. I was able to meet other women who also got the gastric sleeve the same day I did, but with different doctors, and I have to say seeing how they were struggling with recovering broke my heart. All doctors have different techniques, but myself and another patient of Dr. Nieto were the only ones that were recovering with no issues at all. The pre op diet/plan that you get with the nutritionist prepares your body so well for recovery. I 1,000 percent recommend Dr. Nieto and his team for bariatric surgery!
  
 
       
   Montse Valdez 
 2024-07-11
 
 
 Trustindex verifies that the original source of the review is Google. Hola buenas noches, por mi parte el trato siempre fue excelente, desde la primera cita con el doctor nieto para mi valoración super amable y atento, una vez que me dio mi fecha, de inmediato me mandaron mi hoja de confirmación por parte de su equipo siempre atentos a cualquier duda, el días antes de la operación confirmando mi asistencia, el día de la operación todos muy amables en el hospital y su equipo, a la hora de la cirugía explicándome detalladamente todo muy profesional, doctor nieto pasa do a realizar sus respectivas reviciones, excelente servicio
  
 
       
   HSR Reseda 
 2024-07-02
 
 
 Trustindex verifies that the original source of the review is Google. Dr Nieto it was a great experience with the doctor and his team after the surgery I was feeling great walking good I will recommend the doctor 100 💯
  
 
       
   Jamileth Jimenez 
 2024-06-24
 
 
 Trustindex verifies that the original source of the review is Google. El mejor doctor, un procedimiento rápido, la atención, información como explicación del procedimiento y las personas que lo apoyan tienen la misma calidad humana.
  
 
       
   Daniel Ramírez 
 2024-06-20
 
 
 Trustindex verifies that the original source of the review is Google. Me pareció una experiencia muy buena ya que los doctores al igual que enfermeras fueron muy atentos al momento de entrar a cirugía y al salir. Me brindaron la comodidad de lugar y atención por lo cual estuvieron al pendiente de cualquier cosa que necesitara .
Al momento de retírame la despedida de los enfermeros y doctora fue muy agradable por el cual me brindaron su apoyo por si tenía alguna duda durante mi recuperación en casa .
Finalmente recomido al doctor Felipe Nieto Segura para cualquier tipo de cirugía ya que es un doctor excelente .