Day of Bariatric Surgery
Mar. 3, 2023 - Weight Loss Surgery in Delaware: Day of Bariatric Surgery
On this Bariatric Friday, Kemal Erkan, Chairman of American Surgery Center, is speaking with Dr. Isaias Irgau, President of Christiana Institute of Advanced Surgery (CHRIAS) and specialist in bariatric surgery, to discuss the patient’s “day of” bariatric surgery. American Surgery Center is an accredited center that is nationally and locally recognized as a center of excellence for bariatric surgery.
Before bariatric surgery, there is an extensive preparation period that can take as long as six months. This period can vary in length with each patient due to differing insurance plans. During this time, the patient will be evaluated by numerous medical professionals to ensure the surgery is right for them. Morbid obesity is not a matter of appearance or preference; it is a disease that can be resolved with correct measures taken. Morbid obesity is defined as being 100 pounds over the ideal body weight or having a body mass index (BMI) of 40 or greater. Morbid obesity can also have accompanying comorbidities such as type 2 diabetes, sleep apnea, heartburn, and many more. Bariatric surgery is the most effective treatment for these potentially life-threatening conditions. If a person has a BMI of 35 and one of these coinciding diseases, they may also be eligible for bariatric surgery.
After surgery a person will not be able to eat as much as they used to due to reduction in the size of the stomach. Erkan and Dr. Irgau explain how patients become filled with nerves and excitement as the surgery date approaches. Patients are excited because they know a solution is coming, yet the nerves are associated with undergoing surgery. This is why there are crucial steps before this point that the patient must agree to do. Dr. Irgau mentions the meal plan patients must follow for the two weeks leading up to bariatric surgery. This meal plan is not about losing weight; the main goal of this diet is to shrink the size of the liver, so there is easier access to the stomach during the procedure. The liver must be small enough to move and manipulate for a successful surgery.
The patient must stop eating and drinking at midnight the night before surgery, and the surgeon may request the patient to take certain medications with a sip of water. To avoid discomfort, they are typically instructed to take 1,000 milligrams of Tylenol at home and then given other medications upon arrival at the appointment.
A known complication of surgery is developing blood clots and being overweight increases the risk of having blood clots. When the anesthesia wears off, the patient needs to be as quick as possible. Getting the body in motion is the key to avoiding blood clotting. The movement tricks the brain into thinking the body is fine and did not just undergo surgery. If the patient is horizontal after bariatric surgery, the brain will convince the body it is sick. The sooner the patient is active, the body will assume nothing major has changed. At American Surgery Center, bariatric surgery is performed as an outpatient. Erkan and Dr. Irgau relay that the average discharge following surgery is approximately six to eight hours. Out of the last 400 cases, only 2 individuals had to stay overnight.
Hydration is an important aspect following bariatric surgery. After surgery, the stomach is much smaller, and the patient cannot drink a lot at one time. It is imperative that the patient sips small amounts of water continuously. Most foods consumed hydrate the body, and after surgery when the patient is eating less food the water intake decreases. The patient must actively make up for this deficiency. Monitoring the color of urine is a great way to assess hydration level. IV fluids may be given to the patient after surgery if the patient is really struggling with fluid intake.
A support system for the patient is extremely important following bariatric surgery. A patient is not permitted to drive for several days and may need assistance throughout the day. There are physical limitations. For example, patients will not be able to lift heavy objects for a month following the procedure; however, they should try to remain active and walk frequently. Walking and hydrating are the two most important aspects to recovery from bariatric surgery. It is important for the patients to communicate the difficulties they are having so the medical professionals can offer support and aid in their recovery. Communication is key to this life altering surgery, which will have a profound impact on the quality of life for the patient.