Mhy12784

The bigger issue is why/how do you have NO spleen ? If you had emergency (or even elective) surgery extensive adhesions could be an issue. Which if bad enough could cause them to complicate, substantially extend, or cancel your surgery. I recall a patient who had an emergency splenectomy from a trauma, and the surgeons spent 4+ hours taking down adhesions before canceling the case. The patient eventually came back (this time they were prepared to do the case open if need be) but were ultimately able to finish the case after 6-8 hours.
The surgeon should have a good idea of your circumstances before the case, and would hopefully discuss any concerns he has

In addition to insurance (which is super important) ľ would look at the surgeons volume and how recently they did their cases. I would absolutely not go to a bariatric surgeon who isn't doing a substantial amount of cases, specifically the case I'm going to them for.

The surgeon I work with requires them on all patients. It really doesn't make sense to me why you wouldn't do one preoperatively.
For starters they could identify a hiatial hernia that they would repair during your surgery (even if you don't have GERD this could prevent you from getting after your sleeve) . And if you have GERD or more importantly barrets esophagus depending on the extent of it, it could influence your choice of bariatric surgery (ie if you have bad GERD/barretts they might steer you to a bypass instead of a sleeve or band).
I guess if I didn't have insurance or had crap insurance I would consider attempting to skip the endo. But to me it just doesn't make sense not to have one as this is incredibly minor compared to the life-changing bariatric procedure