September 17, 2023

Bariatric Surgery 18 Frequently Asked Questions

1. I have major obesity issues, however I hesitate to have surgical procedure, what is the risk that I have during Bariatric Surgical procedure

Every medical procedure involves inherent risks, and bariatric surgery is no exception. There is a small risk of serious complications associated with bariatric surgery. Those at the highest risk are typically older individuals with a history of conditions such as deep-vein thrombosis (blood clots), pulmonary or cardiac issues, and extreme obesity. The most effective way to minimize the risk of complications is to attend all scheduled follow-up appointments and adhere to your prescribed diet and lifestyle plan.

There are potential temporary and also long-lasting complications from having weight loss surgical treatment that include:

  • Irregularity in bowel movements, diarrhea or constipation
  • Saging skin
  • Wound infections: It can occur up to three weeks after surgical treatment. Signs and symptoms consist of soreness as well as warmth, discomfort, or thick drainage (pus) from the surgical incisions. Wound infections call for prescription antibiotics and often further surgical procedure like abscess drainage.
  • Dumping Syndrome: This takes place after consuming high-sugar foods after weight management surgery. Soft drinks or fruit juices are commonly to blame. The sweet food passes to the small bowel very fast, attracts water to the bowels, causes bloating, diarrhea and also can trigger nausea or vomiting, dissiness, palpitations and weakness.
  • Gallstones: As much as 50% of patients will create gallstones after gastric bypass surgery, yet these are generally harmless. Sometimes, gallstones can create nausea, vomiting, and also stomach pain. Around 15% to 25% of individuals require surgery to remove their gallbladder after gastric bypass surgery.
  • Blood in feces: Blood in feces looks like reddish or black feceses, which may be major. Immediate medical attention is needed for this side effect.
  • Blood clots to the lungs: This side effect is uncommon, happening less than 1% of the moment. They can be lethal. Yet embolism can usually be protected against with blood-thinning medications and also frequent activity.
  • Leaks in the brand-new connections made by the surgical procedure are rare, however serious. Most of the leaks usually occur within 5 days of the surgery.

2. What is the risk of death with the bariatric surgery?

The 30-day mortality rate for sleeve gastrectomy was 0.08 percent, which translates to 8 patients out of 10,000, whereas the risk for gastric bypass was 0.14 percent, indicating 14 individuals out of 10,000. These rates are comparable to those of gallbladder removal or hip replacement surgeries.

3. What is the right surgery for me, gastric sleeve or gastric bypass?

The choice regarding which procedure to undergo is typically determined during the initial consultation between you and one of our bariatric surgeons. Many other bariatric centers offer only a single type of procedure, which can limit your options. However, at Istanbul Bariatric Centre, we specialize in nearly all types of bariatric surgeries. The most suitable option will be determined after a thorough consultation and assessment of your preoperative test results.

Gastric Bypass: In this procedure, your surgeon will employ surgical staples to form a small stomach pouch, which serves as your new stomach. This pouch has a capacity of approximately one small cup of food. The rest of your original stomach remains in place, but food will no longer pass through it.

Subsequently, your surgeon will make an incision in your small intestine beyond the stomach. One end of the small intestine will be connected to the small stomach pouch, and the other end is connected further down on the small intestine, creating a configuration resembling a “Y” shape, although sometimes it’s done with only one connection, forming a loop. This part constitutes the bypass aspect of the procedure. It’s worth noting that the remainder of your stomach remains intact and continues to release digestive chemicals from the pancreas to assist in the gradual digestion of food coming from the small pouch. Our team primarily utilizes the laparoscopic method for many gastric bypass surgeries.

Gastric Sleeve: In this procedure, the surgeon staples and removes a significant portion of your stomach (about 75-80%), creating a tube-shaped stomach known as a gastric sleeve. This newly shaped stomach remains connected to your small intestine, so the original path of the digestive system remains unchanged. Post-surgery, your stomach will have a reduced capacity of around 2-3 ounces. You’ll experience a sensation of fullness sooner during meals because of the smaller stomach size. Additionally, your hunger will decrease as most of the tissue (approximately 90%) responsible for producing the “hunger hormone” known as ghrelin will be removed. It’s important to note that this procedure is not reversible.

Types of bariatric surgery. Stomach reduction

4. What is the age limitation for bariatric surgeries?

There is no specific upper age limit for this type of surgery; however, the procedure carries higher risks for individuals over the age of 65. Bariatric surgery can be safely performed on carefully screened patients aged over 70, resulting in modest improvements in comorbidities. In an older population, laparoscopic sleeve gastrectomy is both safe and effective, but weight loss outcomes tend to be more moderate compared to younger surgical candidates. Thoughtfully selected elderly patients can still benefit from bariatric surgery.

5. How long will it take to get back to function?

Certain individuals with desk-bound jobs have resumed work within one to two weeks post-surgery. However, if your job involves more physical demands, it might require up to six weeks before you can return to work.

6. Which examinations are necessary before undergoing surgery?

The range of medical and psychological comorbidities associated with obesity necessitates a collaborative approach by a multidisciplinary team during the preoperative assessment of morbidly obese patients. This evaluation is crucial for enhancing the postoperative results. It may involve assessments of heart, lung, psychiatric, and endocrine health before surgery. These evaluations help in identifying patients who may not benefit from surgery while also identifying those deemed suitable candidates. Additionally, preoperative nutritional counseling is essential for obtaining a comprehensive dietary history and outlining dietary procedures before and after surgery.

7. What should I put in my bag on the day of the surgery?

6 Need to Have Items For Your Hospital Keep

Whether you have stomach bypass, lap band surgery, gastric sleeve surgery, or duodenal switch surgical treatment the items below are extremely recommended.

Chapstick as well as Lotion

Following weight loss surgery, you are usually prohibited from consuming or drinking anything for a period of time. Furthermore, your body responds to surgery as if it’s under attack, diverting most of its fluids to vital organs. Consequently, this can leave your skin and lips particularly dry.

Comfy Garments

Your doctor will likely encourage you to get up and move shortly after surgery, and you might even be able to shower the following morning. However, the bending required to put on regular clothes can be painful. It’s a good idea to have comfortable attire that’s easy to slip on and off as needed. At this point, you won’t be focused on fashion, believe me!

Cellular phone and iPad or Kindle Fire

Even though you’ll likely feel drowsy and drift in and out of sleep, you’ll want to stay connected. Bring your mobile phone to keep your friends and family updated on your progress. An iPad or a Kindle Fire is an excellent way to watch movies or surf the web. Consider downloading a light novel or a book by your favorite author to pass the time.

Slippers Or Socks with Tread

Acquire a pair of cozy slippers or socks with non-slip soles. Your balance might be a bit unsteady, and hospital floors can be unclean. While hospitals typically provide these, it’s nice to have your own comfortable slippers or warm socks to keep your feet cozy and secure.

Mouth Wash or Breath Spray

You might experience bad breath, and you may not feel like getting up to brush your teeth, especially if you have visitors. Consider bringing a small breath spray with you so you won’t have to worry about causing any discomfort with bad breath. Remember, you’ve recently undergone changes in your digestive system (more so with some procedures), so even if you typically don’t have bad breath, it’s likely during this time, and a quick solution can be handy.

Your Fave Pillow

You will experience discomfort, and your sleep may be intermittent. It’s a good idea to have your preferred pillow with you. You can also use it for the car ride home, especially if it’s a long journey. If you’re comfortable sleeping on any pillow, consider bringing a pillowcase. Hospital pillowcases often go through heavy bleach washes and can become scratchy and stiff. Just remember to take your pillowcase back home with you.

Space Fragrance

After surgery, you might experience some flatulence, and the odor might catch you off guard. If you prefer to maintain a pleasant environment in your room and don’t want everyone to share the odor, consider bringing a bottle of air freshener with you.

Preoperative Diet Plan

  

8. Will the procedure be done laparoscopically?

Gastric sleeve or bypass procedures are typically performed using laparoscopy, which involves creating five to six small incisions in the abdomen through which a small camera and surgical instruments are inserted.

The surgeon employs staples to separate the upper portion of the stomach from the lower part, creating a small stomach pouch. This pouch restricts the amount of food that can be consumed.

Next, a portion of the small intestine known as the jejunum is linked to the small stomach pouch, enabling food to bypass the lower stomach (duodenum).

This bypass decreases the intake of calories and nutrients by the body, contributing to weight loss.

9. Just how much is the average weight that I will lose monthly?

The amount of weight you’ll shed is influenced by several factors, including your diet, exercise, lifestyle, and your determination to adopt new habits. While the surgeon’s choice of stomach size and roux limb length can have a slight impact on weight loss, these surgical distinctions usually have minimal significance.

Many people lose an average of 0.9-1.8 kg, a week for the first 6 months to a year complying with surgical treatment.

The most substantial weight loss typically occurs in the initial month post-surgery due to changes in eating habits and the shedding of water weight. Following that, you can anticipate an average monthly weight loss ranging from 8 to 16 pounds during the first six months. For most patients, the typical total weight loss after one year amounts to approximately 60% of their excess body weight.

Weight reduction reduces after 6 months, however adding healthy way of living interventions can aid.

10. How much pain can I anticipate after surgical treatment?

Discomfort at the incision site or discomfort due to your body’s positioning during surgery can be expected. Additionally, some individuals may encounter neck and shoulder discomfort, which occurs as a result of the body reabsorbing the gas used during the surgical procedure.

If your pain impedes your mobility, please inform your healthcare team. Pain is managed through oral medications, and they are most effective when taken consistently. It’s important not to wait until your pain becomes unbearable before requesting another dose; maintaining a steady level of medication in your bloodstream helps keep pain under control.

To minimize the necessity for opioids, the pain management approach incorporates various treatment methods. If oral opioids are prescribed, they will only be used during the initial few days post-surgery.

11. Will I need to take a vitamin supplement after Excessive weight surgery?

Following bariatric surgery, it's highly recommended that you continue taking vitamins for the remainder of your life. Non-compliance with these nutritional requirements can lead to serious health issues. Additionally, your mood, energy levels, and concentration can be negatively affected by a lack of proper vitamins after bariatric surgery. Regular blood tests are necessary every three months during the first year post-surgery and annually thereafter.

Allow's begin with some guidelines of what not to take:

No gummy vitamins.

Avoid children's vitamins which are incomplete.

Think about added supplementation if you take an 'all-in-one' multivitamin with calcium and iron.

Selecting a Multivitamin

Depending on the brand as well as dimension of the vitamin you'll need to take in between 1 and also 4 pills, or chewable tablets daily. Review the label to figure out the amount of are called for daily.

It needs to include a minimum of 18mg of iron. If you choose a multivitamin without iron, you'll require to take iron supplements individually.

Your specialist or dietitian need to offer support on just how much iron you'll need after surgical procedure.

It ought to have at least 400 mcg of folic acid.

A minimum of 200% of the suggested day-to-day intake for the majority of, if not all, of the nutrients detailed on the tag.

It includes at least 2mg of copper.

Should contain 12 mg of thiamin.

At the very least 3,000 IU of Vitamin D.

12. Will I need to take healthy protein supplements after Weightloss Surgery?

Proteins are a fundamental component of every cell, tissue, and organ within our bodies. These proteins in our body are in a constant state of breakdown and replacement. Unlike some other nutrients, the body doesn’t store protein for future use. Hence, it’s crucial to consume an adequate amount of high-quality protein; otherwise, the body’s well-being can be compromised. When protein intake falls short, the body resorts to breaking down lean body mass to compensate for insufficient dietary intake. This loss of lean body mass is inevitable for patients undergoing weight loss surgery or individuals adhering to a very low-calorie diet. To minimize this loss, it’s essential to ensure an adequate intake of high-quality protein. Many medical weight loss programs recommend a daily protein intake ranging from 60 to 80 grams.

13. When can I do work out once again?

Workout after surgery is definitely vital, and it might be one of the most important aspect that can assist an individual attain enduring and effective weight loss.

Excercise Regimen Would Be Like This

Begin walking from day 1.

Boost your walking every day. Add other cardio exercises like swimming and bicycle riding as your cosmetic surgeon permits and also as you really feel so likely.

Begin light weight training and also sit-ups as your cosmetic surgeon permits. Increase weights as well as variety of representatives slowly. This type of exercise will certainly raise muscular tissues mass which enhances stamina, enhances bone thickness, and also boosts metabolic rate.

Think about making use of an individual fitness instructor to inform one about exercise, boost motivation, and assist ensure correct regimens.

Independent of what phase an individual might be in before or after surgery, there are particular standard secure and also trusted rules to follow in regard to workout:

Consider your objectives as well as how you wish to achieve them. You can achieve it!

Usage exercise in mix with weight-loss surgery to make best use of results.

Bear in mind every person begins with a various state of physical capability as well as stamina. Progressively boost your task as well as workout capacity. Moderate pain from exercise serves, yet discomfort ought to be avoided. Neglect the saying, "No pain no gain."

Consume lots of water before, throughout, as well as after exercise.

14. What negative effects or unwanted symptoms might I experience?

Extensive research has provided us with valuable data regarding the adverse outcomes of gastric bypass surgery. The initial category of adverse effects pertains to early complications, including bleeding, leaks, blood clots, and issues involving other organs such as the heart, lungs, or kidneys. The incidence of these significant complications has decreased to approximately 8%, and the mortality rate associated with the surgery is approximately 0.1%, equating to one in a thousand cases. It’s essential to consider that these figures are typically much lower than those associated with other common forms of standard surgery.

Long-term consequences of gastric bypass surgery encompass potential complications arising from the altered intestinal tract route, including blockages, twisting, or the need for surgical adjustments. Nutritional deficiencies can gradually manifest, particularly in iron, Vitamin B12, and Vitamin D, leading to fatigue, neuropathy, and decreased bone density over time. An unusual occurrence known as “dumping syndrome” induces discomfort, dizziness, and a rapid heartbeat in some individuals when they consume excessive sugar.

15. Is it possible to undergo bariatric surgery if I've had previous abdominal surgeries or if I have a hernia or stoma?

Prior abdominal surgery increases the duration of both bariatric surgery itself and the postoperative hospital stay, but it does not influence the long-term outcomes of bariatric treatment.

16. Can I smoke after surgery?

Regarding cigarette smoking, we have advised all our patients to quit for at least six weeks before their medical procedures, primarily for safety and to minimize potential complications. Although some individuals might contemplate resuming smoking after surgery, it is strongly discouraged.

It’s best to completely abstain from smoking after surgery, as surgery can be a strong motivation to quit smoking. If you find yourself needing to smoke again, it’s advisable to wait for at least four weeks. Keep in mind that certain parts of your body can remain susceptible to infection for weeks to months after surgery, making smoking unwise during this period.

17. Exactly how large is the scar from Bariatric Surgery?

In the 1990s, less invasive multi-port laparoscopic techniques emerged, involving the insertion of surgical instruments through three to five small incisions in the upper and middle abdomen. This approach remains widely adopted and proves highly effective in minimizing scarring from stomach sleeve incisions and reducing the risk of complications.

18. What is the objective of endoscopy?

Upper gastrointestinal (GI) endoscopy is performed to investigate and address potential upper GI issues. This is particularly important after gastric bypass surgery, as gaining non-surgical access to the lower stomach and duodenum can pose challenges.

If you have any further questions about bariatric surgery, please write a review or contact us.

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