The LRYGBP is generally less painful. Patients are routinely out of bed and ambulating independently 2-4 hours after surgery. The small incisions lead to far less pain. The gas from the laparoscopy is the most uncomfortable part. The left lower incision is the largest and moist painful, but usually 1-2 weeks post operatively.
You can try to prearrange this through the hospital bed management services. ALL bariatric patients at Saint Clares Dover have private rooms.
General anesthesia is necessary. No other option is available.
Patient controlled analgesia pumps are the routine for the first 24 hours. This allows the patient immediate access and maximal control. After the first 24 hours, generally oral agents. Epidural catheters are not used due lack of necessity and possible complications related to the catheters themselves.
No. Neither have been necessary.
Gastric Bypass patients generally do get a drain, however it will usually be removed prior to discharging the patient.
Admission is same day only. You will have to be at the hospital several hours before the procedure.
Surgery usually requires less than 2 hours from the time of leaving the holding area. You will be in recovery for 2 hours prior to transfer to the surgical floor. Your family will speak to the surgeon immediately after the procedure, but won’t be immediately allowed into the recovery room. They will meet you on the surgical floor afterward.
In most cases no. If you have had prior abdominal surgery, you should try to get operative reports from the hospital where it was done for the surgeon to review.
Prior to completion of the operation, while still under anesthesia, you undergo upper endoscopy to evaluate the attachment of the stomach to the intestine. This can detect leaks, bleeding or other abnormalities. Its done prior to the end of surgery so repair of any abnormalities can be undertaken BEFORE problems occur. No patient is allowed to awaken and go to recovery until the attachment is fully tested and proven to not leak. This also eliminates the need for x ray upper GI testing the day after surgery.
No ice chips or liquids are allowed for the first 24 hours. If the surgeon decides its ok, generally liquids and ice start on post operative day 1. Intravenous fluid is continued throughout this period.
No. You should follow a nutritionally balanced program leading up to surgery to give your body what it needs to heal. This includes a multivitamin and protein supplement. Most vitamins are water soluble and will not be stored for any effective duration to affect your recovery.
The risks are no different after surgery than they were before surgery. The surgery has not been reported to increase the likelihood of developing ANY cancers. It will not prevent cancer either. Thankfully, cancer of the stomach is quite rare. The detection of abnormalities in the lower stomach is far more difficult after bypass due to inability to view it with an endoscope (it’s been excluded).
You can get ulcers in the gastric pouch although they are rare. The usual causes are medications (aspirin, non steroidal anti inflammatories and steroids), and cigarette smoking (increases risk by a factor of 11x). You can develop ulcers in the remnant of the lower stomach for the same reasons. These are NOT detectable by endoscopy (it’s been excluded).
Aspirin, non steroidal anti inflammatories and steroids should be avoided if possible. If they are a necessity due to other medical issues, avoidance for as long as possible is advised (6 weeks preferably). If the medications are necessary to sustain the patient, they are restarted as needed with the knowledge that the risk of bleeding, ulceration and perforation are all increased. In general cox 2 inhibitors are preferred over the others if medicines are absolutely necessary. Diuretics are also generally avoided due to patients’restricted ability to ingest adequate fluids to avoid dehydration. Coumadin and other blood thinners require close monitoring after surgery and doses may change radically. Most other medications are perfectly well tolerated.
Help should be available but this is not different than in any other surgery. Depending on your life circumstances, you may need to arrange for child care or home aide assistance for shopping. This is not common. Most patients arrange a schedule for on call aid with their family members or support people. You will NOT be bed or house bound.
This is a patient specific item. Some react as if they had not undergone surgery and are active without interruption immediately. Some require 4-6 weeks before returning to their usual routines. The most common complaint is fatigue and adjustment issues, NOT pain. Most return to work in 2-3 weeks.
The surgeons will discuss signs of post operative trouble preoperatively. Abdominal pain out of proportion to expected wound pain, temperature elevations to 101.5 or above, persistent vomiting, abdominal distention with inability to pass gas, and redness, swelling or drainage of the wounds should prompt you to notify the surgeon.
There is FAR less pain. Many patients go home the same day with minimal pain. The gas from the laparoscopy is the most uncomfortable part.
You can try to prearrange this through the hospital bed management services. ALL bariatric patients at Saint Clares Dover have private rooms.
General anesthesia is necessary. No other option is available.
Oral agents with injections if needed.
No. Neither have been necessary.
No drains are used.
Admission is same day only. You will have to be at the hospital several hours before the procedure. Many times, it’s a same day discharge to home.
Surgery usually requires less than 2 hours from the time of leaving the holding area. You will be in recovery for 2 hours prior to transfer to the surgical floor. Your family will speak to the surgeon immediately after the procedure, but won’t be immediately allowed into the recovery room. They will meet you on the surgical floor afterward.
In most cases no. If you have had prior abdominal surgery, you should try to get operative reports from the hospital where it was done for the surgeon to review.
Prior to completion of the operation, while still under anesthesia, you undergo upper endoscopy to evaluate the sleeve. This can detect leaks, bleeding, areas of narrowing or other abnormalities. Its done prior to the end of surgery so repair of any abnormalities can be undertaken BEFORE problems occur. No patient is allowed to awaken and go to recovery until the area is fully tested and proven to not leak. This also eliminates the need for x ray upper GI testing the day after surgery.
After fully awakening in recovery you may be allowed to sip liquids at the discretion of the surgeon.
No. You should follow a nutritionally balanced program leading up to surgery to give your body what it needs to heal. This includes a multivitamin and protein supplement. Most vitamins are water soluble and will not be stored for any effective duration to affect your recovery.
The risks are no different after surgery than they were before surgery. The sleeve has NOT been associated with stomach or esophagus cancers.
You can develop ulcers, but they are rare. Smoking is a risk factor.
Aspirin, non steroidal anti inflammatories and steroids should be avoided if possible. If they are a necessity due to other medical issues, avoidance for as long as possible is advised (6 weeks preferably). If the medications are necessary to sustain the patient, they are restarted as needed with the knowledge that the risk of bleeding, ulceration and perforation are all increased. In general cox 2 inhibitors are preferred over the others if medicines are absolutely necessary. Diuretics are also generally avoided due to patients’restricted ability to ingest adequate fluids to avoid dehydration. Coumadin and other blood thinners require close monitoring after surgery and doses may change radically. Most other medications are perfectly well tolerated
Help should be arranged with family members or support people. It is rarely necessary. Most patients return to usual activities the following day.
This is a patient specific item. Each individual is different. The majority return to usual activity in 24-72 hours and to work in 1-2 weeks. The most common complaint is a lack of dietary variety in the first post operative month.
The surgeons will discuss signs of post operative trouble pre-operatively. Abdominal pain out of proportion to expected wound pain, temperature elevations to 101.5 or above, persistent vomiting, abdominal distention with inability to pass gas, and redness, swelling or drainage of the wounds should prompt you to notify the surgeon.
The LAP-BAND® is far less painful. The incisions are very small. The port site is the largest wound and may be tender, but usually easily tolerated. The gas from the laparoscopy is the most uncomfortable part.
You will be going home the same day of surgery and will not need a bed.
General anesthesia is necessary. No other option is available.
No. Neither have been necessary.
No drains are used.
You are not admitted unless special circumstances occur. It’s a same day discharge to home.
Surgery ranges 40 minutes to 1 hour. You will remain in the recovery room until fully awake, then may go to radiology for post surgical testing. Your family will speak to the surgeon immediately after the procedure, but won’t be allowed into the recovery room. After return from radiology you will go to second stage recovery where you will be allowed visitors and ultimately be discharged home.
In most cases no. If you have had prior abdominal surgery, you should try to get operative reports from the hospital where it was done for the surgeon to review.
After fully awakening in recovery, you go to radiology for an x ray swallow study to confirm position of the band and rule out obstruction or leak. After this is confirmed, you may begin liquids. Under some circumstances the Xray testing can be done immediately prior to you awakening in the OR.
After fully awakening in recovery you may be allowed to sip liquids at the discretion of the surgeon. After the completion of the x ray, you begin ice and liquids.
No. You should follow a nutritionally balanced program leading up to surgery to give your body what it needs to heal. This includes a multivitamin and protein supplement. Most vitamins are water soluble and will not be stored for any effective duration to affect your recovery.
The risks are no different after surgery than they were before surgery. The band has NOT been associated with stomach or esophagus cancers.
You can develop ulcers in the pseudopouch above the band due to medication use (aspirin, non steroidal anti inflammatories and steroids), over tightening of the band, or cigarette smoking (increases risk by a factor of 11x). Ulcers may occur at the level of the band itself. Usually due to over tightening. Ulcers may occur in the lower stomach. These are usually medication or smoking related as above.
Aspirin, non steroidal anti inflammatories and steroids should be avoided if possible. If they are a necessity due to other medical issues, avoidance for as long as possible is advised (6 weeks preferably). If the medications are necessary to sustain the patient, they are restarted as needed with the knowledge that the risk of bleeding, ulceration and perforation are all increased. In general cox 2 inhibitors are preferred over the others if medicines are absolutely necessary. Diuretics are also generally avoided due to patients’restricted ability to ingest adequate fluids to avoid dehydration. Coumadin and other blood thinners require close monitoring after surgery and doses may change radically. Most other medications are perfectly well tolerated.
Help should be arranged with family members or support people. It is rarely necessary. Most patients return to usual activities the following day.
This is a patient specific item. Each individual is different. The majority return to usual activity in 24-48 hours and to work in a week. The most common complaint is lack a of dietary variety in the first post operative month.
The surgeons will discuss signs of post operative trouble pre-operatively. Abdominal pain out of proportion to expected wound pain, temperature elevations to 101.5 or above, persistent vomiting, abdominal distention with inability to pass gas, and redness, swelling or drainage of the wounds should prompt you to notify the surgeon.
Most patients require between 60 and 80 grams daily
It needs to be taken in divided doses. The body cannot absorb more than approximately 30 grams at once.
Not from the standpoint of providing protein for the metabolism. Some people find soy easier to digest. Some find that whey based protein causes loose stools and gas.
There are many available options. Brown rice protein, meats and dietary items.
No one requires you to drink the shakes. We require that you reach a specific goal of protein intake daily. What form you take it in has no bearing on success or failure. Most patients will take it in the form of shakes because they come in many flavor varieties and are generally high in protein and low in carbohydrates. The protein bars are generally not high enough in protein and much higher in carbohydrates. Eating protein rich foods at mealtimes MAY provide the required amounts of daily protein. We do ask patients to calculate their daily dietary protein on occasion to ensure that they are meeting their goals.
No, there are several which look like Kool-aid.
You can mix the material in any way that you wish. It’s the intake that’s important, not the form. Some patients mix powder in large volumes of fluid, some use half the recommended mixture volume of fluid. Some people don’t mix in any fluid. They simply add the powder to their food to boost the protein value. If milk is used, we recommend skim plus because it is low in fat and high in protein.
The recommendations vary by surgeon. Most recommend that you take 60 to 80 grams daily for at least the first year. The body needs all of the help it can get during the period of maximal weight loss. Many recommend that you continue for life. NOTE: as you are able to tolerate more regular foods, you get a higher portion of the requirement during regular meals and supplements become less necessary.
You need additional protein during the period of rapid weight loss to maintain your lean muscle mass. Protein is required for your metabolism to occur. If you don’t provide it, the body will recruit protein from your muscle mass and you can become weak.
You will require a daily multivitamin, and MAY require iron, calcium and additional vitamin supplements.
A standard adult multivitamin with minerals and trace elements is suggested.
Your doctor will check blood work postoperatively to determine the levels of various vitamins and minerals to see if they need supplementation. Sometimes it’s the surgeon, sometimes it’s your primary care physician.
Some medicines have cross reactions and some require separation in dosing from others. Your pharmacist can inform you about interactions. An example is calcium and iron. They should not be taken together for best results because one binds the other leading to less absorption. Ask your pharmacist.
First, do not stop taking your iron! If it’s been recommended, you need it. Constipation is usually most responsive to additional fluid intake. If this is ineffective, a fiber supplement like Metamucil or psylliuym is helpful.
Calcium CITRATE is better than calcium CARBONATE. The citrate form is more easily and thoroughly absorbed. You may need vitamin D in addition. Ask your primary care doctor. To answer the question, no. In some patients they can be dangerous leading to kidney stones or metabolic problems. Ask your primary care physician.
No. You must make wise choices. Your amount of intake has been DRASTICALLY reduced. You need to be sure that anything which goes into your system contributes to your overall health. If you fill up on foods without nutritional value, you will become ill.
Foods rich in simple sugars (fruits, juice, sweets, alcohol) may cause the dumping syndrome (20% of patients)
No, only 20% of patients will experience this syndrome
Your daily menu is determined by you. A variety in the taste and texture of your diet will keep it interesting. The recommended “nutritionally sound” food items are quite varied among the food groups. How they are used and combined makes the difference between a boring and a varied diet.
No. Carbohydrates are part of a varied diet. They should be a small portion of the daily intake. They generally lack the nutritional value of most other foods.
No. This is impossible. You should seek the healthier fats in small amounts as a part of your varied diet.
Hair loss is generally a hormonally mediated issue. Nutrition can play a role but usually does not. Biotin, Zinc and protein MAY be helpful.