Bariatric Surgery: Your Surgical Experience
Before surgery, tests will be done to check your health during the months you and your surgeon have worked together to prepare you for surgery. When it is time for surgery, you will be monitored and kept as comfortable as possible throughout surgery and recovery. After surgery, you may stay in the hospital for one or several days.
Your pre-op exam and tests
Your healthcare provider will see you months before surgery and will request blood tests and other studies. You may be referred to a cardiologist or a pulmonary specialist. These tests help to prepare you for surgery. Chest X-rays may be ordered to check your lungs. An electrocardiogram (ECG) may be done to check your heart rhythm. Your surgeon and dietitian may also ask you to lose some weight before surgery in order to make the surgery safer. You may also meet with a mental health counselor to help cope with the stresses before and after surgery.
To prepare for surgery, you may be asked to:
Lose weight by following a special diet.
Stop taking certain medicines, including aspirin and anti-inflammatories for about a week before surgery. Ask your surgeon what medicines to continue taking. Be sure to mention any over-the-counter medicines, herbs, or supplements you take.
Not binge on food before surgery.
Stop eating and drinking after midnight on the night before surgery, or as instructed.
Just before or on the day of surgery
On or before the day of surgery, you will need to sign any consent forms both for surgery and anesthesia.
An anesthesiologist will talk with you. You will be told about medicines to block pain (anesthetics). These will keep you asleep through surgery. The anesthesiologist will also talk to you about your medical history and about your medicines, and which ones to take on the day of surgery. If you have a CPAP or BiPAP machine for sleep apnea, bring it with you to the hospital.
Reaching the organs
Your surgeon begins the surgery by making one or more incisions in your stomach. For a laparoscopic procedure, several small incisions (port sites) are made. During the procedure, surgical instruments and a tiny camera are put through small tubes placed in these small incisions. The surgeon operates by looking at the organs on a video monitor. For open surgery (laparotomy), the surgeon makes one large incision. Before surgery, your surgeon will explain what type of procedure you are likely to have.
Just after surgery
You may wake up in a recovery room. Or you may be in an ICU (intensive care unit). One or more IV (intravenous) lines may be in place. IV lines deliver fluids and medicines. One IV line may be attached to a PCA (patient-controlled analgesia) pump. You can use this pump to give yourself pain medicines. Tubes may also be in place to drain or suction body fluids. In some cases, a tube may be in your throat overnight to help you breathe. You may also have special leg stockings to help improve blood flow. You may have a urinary catheter that was placed after you went to sleep.
At the hospital
As you recover from surgery, you will be moved to a hospital room. You will be asked to be active as soon as you can, and the nurses can help you get out of bed to move around. This helps speed your recovery, and helps to prevent complications like blood clots in your legs. You will start with liquid nutrition as your body recovers from surgery. You will also be asked to do breathing exercises, using an incentive spirometer. This helps to prevent pneumonia and keep your lungs healthy. X-ray tests may be done to check your progress. Your team will tell you when you're ready to go home.
American Society for Metabolic and Bariatric Surgery: www.asmbs.org
National Heart, Lung, and Blood Institute Obesity Education Initiative: www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt
March 21, 2017
Anesthesia for the Obese Patient. UpToDate, Patient Information: Weight loss surgery and procedures (Beyond the Basics). UpToDate
Meilahn, John, MD,Sather, Rita, RN