Prof Senapati has done more than 1000 various bariatric surgical procedures and has never had to convert them. Pain is minimal, postoperative recovery is quick with early discharge from the hospital. Majority of the patients were discharged the day after surgery, whether they had sleeve gastrectomy, gastric bypass, gastric banding or revisional bariatric surgery. In a small proportion of cases, patients may stay a little longer. usually a day or two more so that they are comfortable, fully mobile and tolerating liquids well.
Your surgeon will determine and explain what you need to do before having obesity surgery, but these are answers to some of the more common questions regarding tests and procedures you may be asked to do in preparation for your surgery.
What are the routine tests before weight-loss surgery?
Certain basic tests, such as a full blood examination (FBE), are performed as part of your initial assessment. In addition, many patients suffer from gastric symptoms so may require barium swallow prior to surgery, and often a glucose test is done to evaluate blood sugar levels. Other tests, such as pulmonary function testing, chest X-ray, echocardiogram, sleep studies, gastrointestinal evaluation, cardiology evaluation, or assessment by a psychologist may be requested when indicated.
What is the purpose of all these tests?
An accurate assessment of your health is needed before surgery to minimise the chance of complications and this will be determined by your surgeon.
Why do I have to have a Gastrointestinal Evaluation?
Patients who have significant gastrointestinal symptoms, such as upper abdominal pain, heartburn, belching sour fluid, etc., may have underlying problems such as a hiatal hernia, gastroesophageal reflux or peptic ulcer.
What can I do before the appointment to speed up the process of getting ready for obesity surgery?
- Select a general practitioner if you don't already have one, and establish a relationship with him or her. Work with your doctor 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 discuss it with your doctor.
- Bring any pertinent medical data to your appointment with the bariatric (weight loss) surgeon - this would include reports of special tests or hospital discharge summary if you have been in the hospital
- Bring a list of your medications with dose and schedule.
Laparoscopic Bariatric Surgery
Does Laparoscopic Surgery decrease the risk?
No. Laparoscopic operations carry the same risk as the procedure performed as an open operation. The benefits of laparoscopic surgeries are typically less discomfort, shorter hospital stay, earlier return to work and reduced scarring.
Will I have a lot of pain?
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.
How long do I have to stay in the hospital?
As long as it takes to be self-sufficient. Although it can vary, the hospital-stay (including the day of surgery) can be between 1- 2 days, depending on the procedure. This will be determined by your surgeon/doctor.
Will the doctor leave a drain in after laparoscopic surgery?
Patients may have a small tube to allow drainage of any accumulated fluids from the abdomen post-operatively. This is a safety measure, and it is usually removed a few days after the surgery. Generally, it produces more than minor discomfort.
If I have laparoscopic bariatric surgery, what can I expect when I wake up in the recovery room?
Some doctors will provide a Patient Controlled Analgesia (PCA) or a self-administered pain management system, to help control pain. Others prefer to use an infusion pump that provides a local anaesthetic in the surgical site to control pain without the side effects of narcotics.
How soon will I be able to walk?
Almost immediately after surgery, doctors will require 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 transportation.
How soon can I drive?
For your own safety, you should not drive until you have stopped taking narcotic medications. Consult your doctor as to when you are able to drive.
What is done to minimise the risk of deep vein thrombosis (DVT)/pulmonary embolism (PE)?
Because a Deep Vein Thrombosis can originate 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 hospitalisation. 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.
What should I bring with me to the hospital?
Personal toiletries and clothing for your stay that are easy to put on and take off.