What you need to know before, during and after gastric bypass surgery.
Prior to surgery you will be required to attend support group meetings and start making lifestyle changes. These changes include the types of food you eat, the way you eat and adding exercise to your routine. These changes will help you get healthier before surgery and assist in easing the transition from before-surgery to after-surgery lifestyle habits.
You will meet with the members of the St. Luke's Bariatric Services Team for all your education needs. Your education session will start with your surgeon, but you will meet with the entire team to learn about diet, exercise, vitamins and minerals, lifestyle changes, your hospital stay, and signs and symptoms of possible complications.
In the evening on the business day prior to your surgery, you will receive a phone call telling you when to arrive for your bariatric or weight loss surgery. Be sure to follow any instructions from your surgeon or physician about what medications you should take if any.
Make sure you follow your surgeon's diet advice for the days leading up to surgery and that you have nothing by mouth after midnight the night before surgery. It will be important for you to shower the evening before and the morning of your surgery to help in the prevention of infection.
On the day of your surgery, you will first come to the Same-Day Surgery Unit, where you will be prepared for your surgery.
After surgery, you will spend a short time in the Post-Anesthesia Care Unit (PACU). When you are awake, you will be transferred to a nursing unit where nurses and aides have been specially trained to care for your needs.
In the nursing unit, your vital signs will be closely monitored. You will be required to wear special compression sleeves on your legs to keep blood clots from forming while you are in bed or the chair. You will receive fluids and medication for pain through a catheter in your vein at first, but you could start on a clear liquid diet the evening of your surgery. You will be able to take medication by mouth once you start on this diet. You will be asked to get out of bed the evening of your surgery and encouraged to walk around the unit.
Possible Complications from Bariatric Surgery
After surgery, some patients may experience minor complications such as nausea, vomiting, diarrhea or wound infections. Serious, but rare, complications may include blood clots to the lungs (pulmonary embolism), pneumonia, leaks in the new stomach pouch-intestine connection, ulcers, bleeding, band erosion/slippage and heart attacks.
Some other common concerns, which could occur later, include vitamin deficiencies or malnutrition, anemia, hypoglycemia, intolerance to alcoholic beverages and excess skin that may require surgical removal.
Complications could require dietary changes, medication or in extreme cases, surgery.
Leaving the Hospital
Your surgeon will determine when you should be discharged. Most patients go home the day after surgery, but you must have someone drive you as you will not be able to drive yourself. You will get specific discharge instructions from your nurse and surgeon describing what medications to take, if any, and what activities you may perform.
Following up with your Surgeon
Roux En Y and Sleeve Gastrectomy
For Roux En Y gastric bypass and Sleeve Gastrectomy patients, appointments will be scheduled at one week, six weeks, three months, six months and yearly after surgery.
Laparoscopic Adjustable Gastric Band
For the Laparoscopic Adjustable Gastric Band, you will need to follow up at one to two weeks, four to six weeks and then every month for approximately four to six months. Most patients need four to six adjustments during their first year following surgery. You may need several adjustments in your second year. You and your surgeon will determine the best course of adjustments based on your weight loss and eating habits. You will need to see your surgeon at least yearly as regular follow-up is associated with greater success.
Follow-up is Crucial!
As you lose weight and start feeling better than ever before, you may be tempted to ignore going back to your surgeon. Some patients may struggle as they move away from surgery and decide they do not want their surgeon to know. Your St. Luke's bariatric surgeon and team want nothing more than for you to be nutritionally and physically safe as well as successful. To achieve this, follow up is crucial. We must keep in contact with you in order to track your progress and your new life in the months and years following the procedure. We may ask you to periodically answer questions by mail or phone.
If you move out of the area, please let us know your new address so we can help with locating a bariatric surgeon who may continue with your follow up care.
Weight loss surgery is not a cure for obesity but rather a tool to help you overcome obesity. It may not take away all your problems but will help you feel better and overcome many obesity-related conditions possibly eliminating the need for many medications. To ensure your surgery is a success, you will need to commit to a different diet and adopt other healthy habits.
Your new pouch will not be able to hold as much food and overeating will make you feel sick or uncomfortable. You will need to eat the right foods in the right way to maintain good health and weight loss. By the end of the first year you should be able to eat the same amount of normally-prepared food that would be placed on a child's plate. You must drink eight cups of fluid every day. Avoid high-calorie foods, beverages, and snacks such as candy and other sweets. Eat protein-rich foods such as eggs, cottage cheese and tender, moist chicken or fish. Chew your food thoroughly to prevent blockage of the small opening leaving your pouch.
You could be at risk for vitamin and mineral deficiencies and must commit to vitamin and mineral supplements for life. Your new diet is described in depth in the packet provided by your surgeon and the bariatric team.
Just as important as proper nutrition, exercise must be included in your new lifestyle. If you found exercise difficult before surgery, losing the weight will make it easier. In short, you must burn up more calories than you consume per day.
If you experience any of the following symptoms up to approximately two weeks after surgery, please call your surgeon or go to the emergency room. If you live locally, please use the St. Luke's Hospital – Allentown Campus Emergency Department, since we are familiar with you and your procedure. However, if you come from a distance, go to your nearest emergency room if symptoms are severe.
- Chest/respiratory/abdominal pain
- Excessive sweating (diaphoresis)
- Fainting or lightheadedness
- Feeling of impending doom
- Shortness of breath
- Persistent headaches
- Fever above 101 degrees F
- Rapid heartbeat
- Shoulder pain