Preparing For Bariatric Surgery
Evaluation for Weight Loss Surgery
Your initial visit with your surgeon and/or nurse practitioner will involve review of your medical history and completion of a physical exam. You will also be asked to see a nutritionist and mental health professional who will help evaluate your knowledge about nutrition and your commitment to change. These assessments are most often a requirement of insurance companies in the approval process and help prepare you for the process of lifestyle changes needed to succeed with postoperative weight loss.
The Impact of Medical Problems
Medical problems, such as serious heart or lung problems, can increase the risk of any surgery. On the other hand, if they are problems that are related to the patient's weight, they also increase the need for surgery. Severe medical problems may not dissuade the surgeon from recommending weight loss surgery if it is otherwise appropriate, but those conditions will make a patient's risk higher than average.
Before Your Appointment
- Select a primary care physician if you don't already have one, and establish a relationship with him or her. Work with your physician to ensure that your routine health maintenance testing is current. For example, women may have a pap smear, and if over 40 years of age, a breast exam. And for men, this may include a prostate specific antigen test (PSA).
- Make a list of all the diets you have tried (a diet history) and bring it to your doctor.
- Bring any pertinent medical data to your appointment with the bariatric surgeon - this would include reports of special tests (echocardiogram, sleep study, etc.) or hospital discharge summary if you have been in the hospital.
- Bring a list of your medications with dose and schedule.
- Stop smoking. Surgical patients who use tobacco products are at a higher surgical risk.
The Hospital Stay
What to Bring
Basic toiletries (comb, toothbrush, etc.) and clothing may be provided by the hospital, but most people prefer to bring their own. Choose clothes for your stay that are easy to put on and take off. Because of your incision, your clothes may become stained by blood or other body fluids.
- Reading and writing materials
- Crossword and other puzzles
- Personal toiletries
- Bathrobe and slippers
- A list of your current medications
Do not bring valuables or your medications to the hospital.
Minimizing Your Risk of Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE)
Because a DVT originates on the operating table, therapy begins before a patient goes to the operating room. Generally, patients are treated with sequential leg compression stockings and given a blood thinner prior to surgery. Both of these therapies continue throughout your hospitalization. The third major preventive measure involves getting the patient moving and out of bed as soon as possible after the operation to restore normal blood flow in the legs.
Every attempt is made to control pain after surgery to make it possible for you to move about quickly and become active. This helps avoid problems and speeds recovery. Often several drugs are used together to help manage your post-surgery pain. While you are still in the hospital, a Patient Controlled Analgesia (PCA), which allows you to give yourself a dose of pain medicine on demand, may be used by your physician. Various methods of pain control, depending on your type of surgical procedure, are available. Ask your surgeon about other pain management options.
Length of Your Hospital Stay
The length of your hospital day is as long as it takes to be self-sufficient. Although it can vary, the hospital stay (including the day of surgery) can be 1-2 days for an adjustable gastric band, and 2-3 days for a laparoscopic gastric bypass or sleeve gastrectomy. Depending on your medical history and other factors, adjustable gastric banding may be done as an outpatient procedures and not require an overnight stay.
Immediately After Surgery
Almost immediately after surgery, nursing staff will assist you to get up and move about. Patients are asked to walk or stand at the bedside on the night of surgery, take several walks the next day and thereafter. On leaving the hospital, you may be able to care for all your personal needs, but will need help with shopping, lifting and with transportation.
For your own safety, you should not drive until you have stopped taking narcotic pain medications and can move quickly and alertly to stop your car, especially in an emergency. Usually this takes 2-3 days for band surgery and 7-10 days for gastric bypass or sleeve gastrectomy surgery.